Medical Emergency Teams: Implementation and Outcome Measurement

✍ Scribed by Peter J. Pronovost M.D., Ph.D., Marlene Miller M.D., Brad Winters M.D., Ph.D. (auth.), Michael A. DeVita M.D., Kenneth Hillman M.D., Rinaldo Bellomo M.D. (eds.)

• Publisher: Springer-Verlag New York
• Year: 2006
• Tongue: English
• Leaves: 312
• Edition: 1
• Category: Library

✦ Synopsis

Why Critical Care Evolved METs? In early 2004, when Dr. Michael DeVita informed me that he was cons- ering a textbook on the new concept of Medical Emergency Teams (METs), I was surprised. At Presbyterian-University Hospital in Pittsburgh we int- duced this idea some 15 years ago, but did not think it was revolutionary enough to publish. This, even though, our fellows in critical care medicine training were all involved and informed about the importance of “C- dition C (Crisis),” as it was called to distinguish it from “Condition A (Arrest). ”We thought it absurd to intervene only after cardiac arrest had occurred,because most cases showed prior deterioration and cardiac arrest could be prevented with rapid team work to correct precluding problems. The above thoughts were logical in Pittsburgh, where the legendary Dr. Peter Safar had been working since the late 1950s on improving current resuscitation techniques, ?rst ventilation victims of apneic from drowning, treatment of smoke inhalation, and so on. This was followed by external cardiac compression upon demonstration of its ef?ciency in cases of unexpected sudden cardiac arrest. Dr. Safar devoted his entire professional life to improvement of cardiopulmonary resuscitation. He and many others emphasized the importance of getting the CPR team to o- of-hospital victims of cardiac arrest as quickly as possible.

✦ Table of Contents

Measuring and Improving Safety....Pages 1-17
The Evolution of the Health Care System....Pages 18-23
Process Change in Health Care Institutions: Top-Down or Bottom-Up?....Pages 24-31
The Challenge of Predicting In-Hospital Iatrogenic Deaths....Pages 32-48
Overview of Hospital Medicine....Pages 49-54
Medical Trainees and Patient Safety....Pages 55-62
Matching Levels of Care with Levels of Illness....Pages 63-79
General Principles of Medical Emergency Teams....Pages 80-90
Potential Sociological and Political Barriers to Medical Emergency Team Implementation....Pages 91-103
Overview of Various Medical Emergency Team Models....Pages 104-115
Early Goal-Directed Therapy....Pages 116-121
Nurse-Led Medical Emergency Teams: A Recipe for Success in Community Hospitals....Pages 122-133
ICU Without Walls: A New York City Model....Pages 134-144
Hospital Size and Location and the Feasibility of the Medical Emergency Team....Pages 145-151
Medical Emergency Teams in Teaching Hospitals....Pages 152-162
The Nurse’s Perspective....Pages 163-172
The Hospital Administrator’s Perspective....Pages 173-183
Personnel Resources for Crisis Response....Pages 184-198
Equipment, Medications, and Supplies for a Medical Emergency Team Response....Pages 199-216
Resident Training and the Medical Emergency Team....Pages 217-231
Teaching Organized Crisis Team Functioning Using Human Simulators....Pages 232-245
Information Systems Considerations: Integration of Medical Emergency Team Clinical Indicators....Pages 246-257
Evaluating Complex System Interventions in Patient Safety....Pages 258-271
Integrating MET into a Patient Safety Program....Pages 272-280
Are Medical Emergency Teams Worth the Cost?....Pages 281-287

✦ Subjects

Intensive / Critical Care Medicine; Emergency Services; Emergency Medicine; Anesthesiology