PURPOSE:Hospitals have demonstrated that implementation of MET can identify patients at risk for clinical deterioration, make an early intervention or triage for appropriate transfer. Significant reductions in cardiopulmonary arrests and unplanned ICU admissions have been observed at institutions with high volume MET calls. Relative to similar hospitals utilizing a MET, our hospital had a relatively low incidence of MET calls even when patients met pre-defined criteria. The aim of this study was to discern factors affecting the decision to call the MET, satisfaction with the MET and the perception of our MET responders (a physician, critical care nurse, and respiratory therapist).
METHODS:This is a prospective, descriptive survey conducted in an urban, tertiary care, university hospital. The survey instrument was designed using items in the published literature about MET teams and investigator designed items (n=24). It was distributed via email to both potential MET activators (nursing, RT, and physician) and MET responders. Respondents were tracked and non-responders were sent a total of three opportunities to complete the survey instrument.
RESULTS:As expected, MET activators reported primarily institutional/cultural barriers to calling MET. Nurses reported concerns related to the primary team as the major barrier to a MET call. Physicians tended to report that they were handling the clinical situation or that they were not notified of the need for MET. MET responders felt many MET calls should have been called earlier in the trajectory of the patient's illness to provide maximal opportunity for improvement in patient care. Furthermore, a significant number of MET calls were immediately transitioned to full Code team calls due to severe cardiopulmonary compromise.
CONCLUSION:MET teams offer the opportunity to reduce morbidity among seriously ill hospitalized patients. To maximize these benefits, barriers to MET team implementation need to be identified and overcome.
CLINICAL IMPLICATIONS:Hospitals should critically evaluate implementation of MET teams and seek to change the institutional culture from low volume MET utilization to high volume MET utilization.
DISCLOSURE:David Pucci, No Financial Disclosure Information; No Product/Research Disclosure Information