Skip to main content

Resident Training and the Medical Emergency Team

  • Chapter
Medical Emergency Teams

Abstract

The need to train and develop house staff for independent practice may conflict with the needs of patients who require rapid stabilization. Finding a healthy balance between the 2, where the patient receives the best care possible, is a challenge to those in academic medicine. Increasingly, data suggests that the traditional models of resident training have in part failed to place the patient first. The contributors to this text believe that the implementation of Medical Emergency Teams will offset some of these shortcomings in care and improve the public accountability of medical education. The MET can also offer opportunities for the development of competencies in patient care for both trainees and established physicians. Likewise, the MET can provide an educational structure from which house staff can learn a great deal more about interdisciplinary teamwork, patient safety, and the responsiveness of health care to patient needs.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Kohn LT, Corrigan JM, Donaldson MS, eds. To Err Is Human: Building a Safer Health System. Washington, DC: National Academies Press; 2000.

    Google Scholar 

  2. Accreditation Council for Graduate Medical Education. Outcome project. Available at: http://www.acgme.org/outcome/. Accessed September 29, 2004.

    Google Scholar 

  3. Buist MD, Jarmolowski E, Burton PR, Bernard SA, Waxman BP, Anderson J. Recognising clinical instability in hospital patients before cardiac arrest or unplanned admission to intensive care. A pilot study in a tertiary-care hospital. Med J Aust. 1999;171:22–25.

    PubMed  CAS  Google Scholar 

  4. Sax FL, Charlson ME. Medical patients at high risk for catastrophic deterioration. Crit Care Med. 1987;15:510–515.

    Article  PubMed  CAS  Google Scholar 

  5. Franklin C, Mathew J. Developing strategies to prevent in-hospital cardiac arrest: analyzing responses of physicians and nurses in the hours before the event. Crit Care Med. 1994;22(2):244–247.

    Article  PubMed  CAS  Google Scholar 

  6. McQuillan P, Pilkington S, Allan A, et al. Confidential inquiry into quality of care before admission to intensive care. BMJ. 1998;316(7148):1853–1858.

    PubMed  CAS  Google Scholar 

  7. Lighthall GK, Barr J, Howard SK, et al. Use of a fully simulated intensive care unit environment for critical event management training for internal medicine residents. Crit Care Med. 2003;31:2437–2443.

    Article  PubMed  Google Scholar 

  8. Schein RM, Hazday N, Pena M, Ruben BH, Sprung CL. Clinical antecedents to in-hospital cardiopulmonary arrest. Chest. 1990;98:1388–1392.

    PubMed  CAS  Google Scholar 

  9. McGloin H, Adam SK, Singer M. Unexpected deaths and referrals to intensive care of patients on general wards. Are some cases potentially avoidable? J R Coll Physicians Lond. 1999;33:255–259.

    PubMed  CAS  Google Scholar 

  10. Hillman KM, Bristow PJ, Chey T, et al. Duration of life-threatening antecedents prior to intensive care admission. Intensive Care Med. 2002;28:1629–1634.

    Article  PubMed  Google Scholar 

  11. Petersen LA, Brennan TA, O’Neil AC, Cook EF, Lee TH. Does house staff discontinuity of care increase the risk for preventable adverse events? Ann Intern Med. 1994;121(11):866–872.

    PubMed  CAS  Google Scholar 

  12. Bellomo R, Goldsmith D, Uchino S, et al. Prospective controlled trial of effect of medical emergency team on postoperative morbidity and mortality rates. Crit Care Med. 2004;32(4):916–921.

    Article  PubMed  Google Scholar 

  13. Franklin CM. Deconstructing the black box known as the intensive care unit. Crit Care Med. 1998;26:1300–1301.

    Article  PubMed  CAS  Google Scholar 

  14. Buist MD, Moore GE, Bernard SA, Waxman BP, Anderson JN, Nguyen TV. Effects of a medical emergency team on reduction of incidence of and mortality from unexpected cardiac arrests in hospital: preliminary study. BMJ. 2002;324:387–390.

    Article  PubMed  Google Scholar 

  15. Bristow PJ, Hillman KM, Chey T, et al. Rates of in-hospital arrests, deaths and intensive care admissions: the effect of a medical emergency team. Med J Aust. 2000;173:236–240.

    PubMed  CAS  Google Scholar 

  16. Leary T, Ridley S. Impact of an outreach team on re-admissions to a critical care unit. Anaesthesia. 2003;58:328–332.

    Article  PubMed  CAS  Google Scholar 

  17. Lee A, Bishop G, Hillman KM, Daffurn K. The Medical Emergency Team. Anaesth Intensive Care. 1995;23(2):183–186.

    PubMed  CAS  Google Scholar 

  18. Bellomo R, Goldsmith D, Uchino S, et al. A prospective before-and-after trial of a medical emergency team. Med J Aust. 2003;179:283–287.

    PubMed  Google Scholar 

  19. DeVita MA, Braithwaite RS, Mahidhara R, Stuart S, Foraida M, Simmons RL; Medical Emergency Response Improvement Team (MERIT). Use of medical emergency team responses to reduce hospital cardiopulmonary arrests. Qual Saf Health Care. 2004;13:251–254.

    Article  PubMed  CAS  Google Scholar 

  20. Goldhill DR, Worthington L, Mulcahy A, Tarling M, Sumner A. The patient-at-risk team: identifying and managing seriously ill ward patients. Anaesthesia. 1999;54:853–860.

    Article  PubMed  CAS  Google Scholar 

  21. Pronovost PJ, Wu AW, Sexton JB. Acute decompensation after removing a central line: practical approaches to increasing safety in the intensive care unit. Ann Intern Med. 2004;140:1025–1033.

    PubMed  Google Scholar 

  22. Landrigan CP, Rothschild JM, Cronin JW, et al. Effect of reducing interns’ work hours on serious medical errors in intensive care units. N Engl J Med. 2004;351:1838–1848.

    Article  PubMed  CAS  Google Scholar 

  23. Wu AW, Folkman S, McPhee SJ, Lo B. How house officers cope with their mistakes. West J Med. 1993;159:565–569.

    PubMed  CAS  Google Scholar 

  24. Pierluissi E, Fisher MA, Campbell AR, Landefeld CS. Discussion of medical errors in morbidity and mortality conferences. JAMA. 2003;290(21):2838–2842.

    Article  PubMed  CAS  Google Scholar 

  25. Howard SK, Gaba DM, Fish KJ, Yang G, Sarnquist FH. Anesthesia crisis resource management training: teaching anesthesiologists to handle critical incidents. Aviat Space Environ Med. 1992;63(9):763–770.

    PubMed  CAS  Google Scholar 

  26. Halamek LP, Kaegi DM, Gaba DM, et al. Time for a new paradigm in pediatric medical education: teaching neonatal resuscitation in a simulated delivery room environment. Pediatrics. 2000;106:E45.

    Article  PubMed  CAS  Google Scholar 

  27. Gaba DM. The future vision of simulation in health care. Qual Saf Health Care. 2004;13(suppl 1):i2–i10.

    Article  PubMed  Google Scholar 

  28. Reznek M, Smith-Coggins R, Howard S, et al. Emergency Medicine Crisis Resource Management (EMCRM): Pilot study of a simulation-based crisis management course for emergency medicine. Acad Emerg Med. 2003;10:386–389.

    Article  PubMed  Google Scholar 

  29. Lighthall G. The IMPES Course: Toward better outcomes through simulator-based multidisciplinary team training. In Dunn WF, ed. Simulators in Critical Care and Beyond. Des Plaines, Ill: SCCM Press; 2004:54–60.

    Google Scholar 

  30. Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001;345(19):1368–1377.

    Article  PubMed  CAS  Google Scholar 

  31. Helmreich RL. On error management: lessons from aviation. BMJ. 2000;320:781–785.

    Article  PubMed  CAS  Google Scholar 

  32. Braithwait RS, DeVita MA, Mahidhara R, et al. Use of medical emergency team (MET) responses to detect medical errors. Qual Saf Health Care. 2004;13:255–259.

    Article  Google Scholar 

  33. Grenvik A, Schaefer JJ, DeVita MA, Rogers P. New aspects on critical care medicine training. Curr Opin Crit Care. 2004;10(4):233–237.

    Article  PubMed  Google Scholar 

  34. Boulet JR, Murray D, Kras J, Woodhouse J, McAllister J, Ziv A. Reliability and validity of a simulation-based acute care skills assessment for medical students and residents. Anesthesiology. 2003;99(6):1270–1280.

    Article  PubMed  Google Scholar 

  35. Gaba DM, Howard SK, Flanagan B, Smith BE, Fish KJ, Botney R. Assessment of clinical performance during simulated crises using both technical and behavioral ratings. Anesthesiology. 1998;89:8–18.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2006 Springer Science+Business Media, Inc.

About this chapter

Cite this chapter

Lighthall, G.K. (2006). Resident Training and the Medical Emergency Team. In: DeVita, M.A., Hillman, K., Bellomo, R. (eds) Medical Emergency Teams. Springer, New York, NY. https://doi.org/10.1007/0-387-27921-0_20

Download citation

  • DOI: https://doi.org/10.1007/0-387-27921-0_20

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-27920-6

  • Online ISBN: 978-0-387-27921-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics