Findings of the first consensus conference on medical emergency teams.
Studies have established that physiologic instability and services mismatching precede adverse events in hospitalized patients. In response to these considerations, the concept of a Rapid Response System (RRS) has emerged. The responding team is commonly known as a medical emergency team (MET), rapid response team (RRT), or critical care outreach (CCO). Studies show that an RRS may improve outcome, but questions remain regarding the benefit, design elements, and advisability of implementing a MET system.



In June 2005 an International Conference on Medical Emergency Teams (ICMET) included experts in patient safety, hospital medicine, critical care medicine, and METs. Seven of 25 had no experience with an RRS, and the remainder had experience with one of the three major forms of RRS. After preconference telephone and e-mail conversations by the panelists in which questions to be discussed were characterized, literature reviewed, and preliminary answers created, the panelists convened for 2 days to create a consensus document. Four major content areas were addressed: What is a MET response? Is there a MET syndrome? What are barriers to METS? How should outcome be measured? Panelists considered whether all hospitals should implement an RRS.



Patients needing an RRS intervention are suddenly critically ill and have a mismatch of resources to needs. Hospitals should implement an RRS, which consists of four elements: an afferent, "crisis detection" and "response triggering" mechanism; an efferent, predetermined rapid response team; a governance/administrative structure to supply and organize resources; and a mechanism to evaluate crisis antecedents and promote hospital process improvement to prevent future events.
Devita
Michael A
MA
Departments of Critical Care Medicine, University of Pittsburgh School of Medicine, PA, USA. DEVITAM@UPMC.EDU
Bellomo
Rinaldo
R
Hillman
Kenneth
K
Kellum
John
J
Rotondi
Armando
A
Teres
Dan
D
Auerbach
Andrew
A
Chen
Wen-Jon
WJ
Duncan
Kathy
K
Kenward
Gary
G
Bell
Max
M
Buist
Michael
M
Chen
Jack
J
Bion
Julian
J
Kirby
Ann
A
Lighthall
Geoff
G
Ovreveit
John
J
Braithwaite
R Scott
RS
Gosbee
John
J
Milbrandt
Eric
E
Peberdy
Mimi
M
Savitz
Lucy
L
Young
Lis
L
Harvey
Maurene
M
Galhotra
Sanjay
S
D019985:Benchmarking; D003422:Critical Care / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006801:Humans; D010348:Patient Care Team / Q000458:organization & administration*; D011785:Quality Assurance, Health Care; D009626:Terminology as Topic; D014481:United States