The evolving story of medical emergency teams in quality improvement.
Adverse events affect approximately 3% to 12% of hospitalized patients. At least a third, but as many as half, of such events are considered preventable. Detection of these events requires investments of time and money. A report in a recent issue of Critical Care used the medical emergency team activation as a trigger to perform a prospective standardized evaluation of charts. The authors observed that roughly one fourth of calls were related to a preventable adverse event, which is comparable to the previous literature. However, while previous studies relied on retrospective chart reviews, this study introduced the novel element of real-time characterization of events by the team at the moment of consultation. This methodology captures important opportunities for improvements in local care at a rate far higher than routine incident-reporting systems, but without requiring substantial investments of additional resources. Academic centers are increasingly recognizing engagement in quality improvement as a distinct career pathway. Involving such physicians in medical emergency teams will likely facilitate the dual roles of these as a clinical outreach arm of the intensive care unit and in identifying problems in care and leading to strategies to reduce them.
Amaral
André Carlos Kajdacsy-Balla
AC
Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Room D108, Toronto, ON M4N 3M5, Canada. andrecarlos.amaral@sunnybrook.ca
Shojania
Kaveh G
KG
D003422:Critical Care / Q000592:standards*; D006801:Humans; D010348:Patient Care Team; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D012107:Research Design