Use of medical emergency team responses to reduce hospital cardiopulmonary arrests -- DeVita et al. 13 (4): 251 -- Quality and Safety in Health Care

Quality and Safety in Health Care 2004;13:251-254; doi:10.1136/qshc.2003.006585
Copyright © 2004 by the BMJ Publishing Group Ltd.
Qual Saf Health Care 2004;13:251-254
© 2004 BMJ Publishing Group Ltd & Institute for Healthcare Improvement
ORIGINAL ARTICLE
Use of medical emergency team responses to reduce hospital cardiopulmonary arrests
M A DeVita1, R S Braithwaite2, R Mahidhara3, S Stuart4, M Foraida4, R L Simmons3 and members of the Medical Emergency Response Improvement Team (MERIT)*

1 Patient Safety Program, Department of Critical Care Medicine, University of Pittsburgh Medical Center Presbyterian Hospital, Pittsburgh, PA, USA
2 Patient Safety Program, Department of Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
3 Patient Safety Program, Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
4 University of Pittsburgh Medical Center Presbyterian Hospital, Pittsburgh, PA, USA

Correspondence to:
Correspondence to:
Dr M A DeVita
University of Pittsburgh Medical Center Presbyterian Hospital, 200 Lothrop Street, Pittsburgh, PA 15213; devitam@msx.upmc.edu

Background: Medical emergency team (MET) responses have been implemented to reduce inpatient mortality, but data on their efficacy are sparse and there have been no reports to date from US hospitals.

Objectives: To determine how the incidence and outcomes of cardiac arrests have changed following increased use of MET.

Methods: Objective criteria for MET activation were created and disseminated as part of a crisis management program, after which there was a rapid and sustained increase in the use of MET. A retrospective analysis of clinical outcomes was performed to compare the incidence and mortality of cardiopulmonary arrest before and after the increased use of MET.

Results: A retrospective analysis of 3269 MET responses and 1220 cardiopulmonary arrests over 6.8 years showed an increase in MET responses from 13.7 to 25.8 per 1000 admissions (p<0.0001) after instituting objective activation criteria. There was a coincident 17% decrease in the incidence of cardiopulmonary arrests from 6.5 to 5.4 per 1000 admissions (p = 0.016). The proportion of fatal arrests was similar before and after the increase in use of MET.

Conclusions: Increased use of MET may be associated with fewer cardiopulmonary arrests.

Keywords: medical emergency team; medical error; cardiopulmonary arrest; resuscitation

abrir aquí:
Use of medical emergency team responses to reduce hospital cardiopulmonary arrests -- DeVita et al. 13 (4): 251 -- Quality and Safety in Health Care