Physician Attitudes Toward Family-Activated Medical Emergency Teams for Hospitalized Children

摘要

Rapid response systems (RRSs), in use in the United States and throughout the world, have been instituted to improve recognition of and response to deterioration of patients outside the ICU, with the goal of reducing cardiac arrest, respiratory arrest, and mortality rates. RRSs include two clinical components, an identification (afferent) and a response (efferent) arm, and two organizational components (process improvement and administrative arms). RRSs entail the deployment of either specialized physician-led medical emergency teams (METs) or nonphysician-led rapid response teams (RRTs). In response to a highly publicized sentinel event in which a deteriorating child experienced critical delays in escalation of care despite her family's persistent concern, many hospitals have enabled families to bypass clinicians and activate METs directly. Also contributing to the adoption of family-activated medical emergency teams (FAMETs) was the 2009 Joint Commission National Patient Safety Goal 16, which set the expectation that hospitals encourage "the patient and family to seek assistance when the patient's condition worsens," although compliance did not require implementation of an RRT or MET.