Download PDF: Clinical Communiqué June 2015 Edition
In this edition
The experience of witnesses called by the Coroners Court
Case #1 Familiarity is key
Case #2 In defence of protocols
Expert Commentary: How to make a better medical emergency team?
This issue of the Clinical Communiqué describes two cases of patient deterioration that resulted in the activation of a hospital Medical Emergency Team (MET). The concept of a MET system was first described in a New South Wales Hospital in 1995 with the goal of improving patient outcomes through early recognition and response to clinical deterioration. The system allowed for staff to call a MET, consisting of doctors and nurses trained in advanced life support, on the basis of clinical concern alone, or on the presence of abnormal physiological variables. It was thought that through prompt intervention and medical treatment, cardiac arrest, unplanned admissions to the intensive care unit (ICU), and death, could be prevented. By 2005, approximately 60% of ICU-equipped hospitals in Australia and New Zealand reported having introduced a MET service.
Now, 20 years later, most health services nationally and internationally have implemented their own versions of the MET system, with their own sets of training guidelines, protocols and practices. Despite the ubiquity of MET systems, we are still learning, and as these cases highlight, we can still do better.
In many ways, the principles behind the MET system are applicable to all healthcare environments, not just acute hospital settings. Leadership, decision-making, communication and task allocation are all critical to the effective performance of a team responding to an emergency, whether that be in an operating theatre, a hospital ward, an outpatient clinic, or community health centres.
Included in this issue is a special feature from the Chair of the Coronial Council of Victoria, Dr Katherine McGrath, who provides valuable insight into the experiences of witnesses called to give evidence at inquest. The expert commentary from Dr Antony Tobin, a senior intensivist and expert in the effectiveness of MET and tracheostomy review teams, details the components of the MET model and the necessary skills and training required to ensure optimal team performance.
This Communiqué marks the completion of our first year back in publication and we are looking forward to presenting our next set of quarterly issues to our readers. We strive to present cases that bring about reflection, communication, and most importantly, changes in practice to improve patient safety. As promised in our first issue, we will continue to evolve and respond to feedback, to provide a resource that challenges, stimulates and educates. To do this, we have designed a short survey that will be sent to all our subscribers in July. Please spare a few moments of your time to complete the survey so that we can hear your views, experiences and suggestions. Once finalised, we will be publishing the results of the survey for our readers.