title: Effects of a medical emergency team follow-up programme on patients discharged from the medical intensive care unit to the general ward: a single-centre experience.
abstract: OBJECTIVE
  The aim of this study was to analyse the effects of the follow-up programme implemented by the Asan Medical Center Medical Emergency Team (MET).
  
  
  METHODS
  A quasi-experimental pre-post intervention design was used, retrospectively reviewed. The follow-up programme includes respiratory care, regular visits and communication between the attending doctors and MET nurse for patients discharged from the medical intensive care unit (MICU) to the general ward. This programme has been implemented since February 2013. Outcomes of patients before and at 1 year after the introduction of the programme were retrospectively reviewed.
  
  
  RESULTS
  A total of 1229 patients were enrolled and divided two groups (Before, n = 624; After the introduction of the programme, n = 625). Forty-six patients (3.7%) were readmitted to the ICU within 72 hours, and there was no significant difference found between the two groups (3.7% versus 3.7%, P = 0.996). Respiratory distress was the most common reason for readmission (67.4%). Cardiac arrest developed in four (0.6%) Before patients; whereas, no cardiac arrest occurred in the After group (0.0%, P = 0.062) cases. A total of 223 patients were discharged to the step-down units. The SOFA (sequential organ failure assessment) score was significantly higher in the step-down unit patients than general ward patients (4.9 ± 2.8 versus 6.2 ± 3.1, P = 0.000). In the analysis restricted to patients discharged to step-down units, unplanned ICU readmissions significantly decreased in the After group (9.3% versus 2.6%, P = 0.034).
  
  
  CONCLUSIONS
  The implementation of the MET follow-up programme did not change the rate of ICU readmission and cardiac arrest; however, its introduction was associated with the reduced ICU readmission of the high-risk patient populations discharged to the step-down unit.
authors.affiliation: Medical Emergency Team, Asan Medical Center, Seoul, South Korea.
authors.forename: Sunhui
authors.initials: S
authors.lastname: Choi
authors.affiliation: Medical Emergency Team, Asan Medical Center, Seoul, South Korea.
authors.forename: Jinmi
authors.initials: J
authors.lastname: Lee
authors.affiliation: Medical Emergency Team, Asan Medical Center, Seoul, South Korea.
authors.forename: Yujung
authors.initials: Y
authors.lastname: Shin
authors.affiliation: Medical Emergency Team, Asan Medical Center, Seoul, South Korea.
authors.forename: JuRy
authors.initials: J
authors.lastname: Lee
authors.affiliation: Medical Emergency Team, Asan Medical Center, Seoul, South Korea.
authors.forename: JiYoung
authors.initials: J
authors.lastname: Jung
authors.affiliation: Medical Emergency Team, Asan Medical Center, Seoul, South Korea.
authors.forename: Myongja
authors.initials: M
authors.lastname: Han
authors.affiliation: Medical Emergency Team, Asan Medical Center, Seoul, South Korea.
authors.forename: JeongSuk
authors.initials: J
authors.lastname: Son
authors.affiliation: Medical Emergency Team, Asan Medical Center, Seoul, South Korea.
authors.forename: YounKyung
authors.initials: Y
authors.lastname: Jung
authors.affiliation: Department of Intensive Care Nursing, Asan Medical Center, Seoul, South Korea.
authors.forename: Soon-Haeng
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea.
authors.forename: Sang-Bum
authors.initials: SB
authors.lastname: Hong
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea.
authors.forename: Jin-Won
authors.initials: JW
authors.lastname: Huh
mesh_terms: D000359:Aftercare; D000368:Aged; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008485:Medical Audit; D008505:Medical Staff, Hospital; D008875:Middle Aged; D010348:Patient Care Team; D010351:Patient Discharge; D056910:Republic of Korea; D012189:Retrospective Studies
keywords: ICU readmission; cardiopulmonary resuscitation; intensive care unit; rapid response team