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Medical emergency team stand-down decision-making: Characteristics, documented decisions, and outcomes documented between single and repeat medical emergency team patients—A retrospective review

Year: 2025

Type: article

Abstract: INTRODUCTION: Decisions to end a medical emergency team (MET) call have been infrequently studied. Premature ending of MET calls may compromise patient outcomes. The aim of the study was to describe clinicians' documentation practices upon ending MET calls and to compare patients with single and repeat MET call activation on the initial call. METHODS: A retrospective review was conducted at a metropolitan hospital in Melbourne, Victoria, from Oct 1st, 2018, to September 30th, 2019. From a total of 8648 initial MET calls, 500 were included in the sample, 250 single and 250 repeated (≥2) MET calls. Data from patients' index MET call were analysed using univariate analyses and descriptive statistics. Variables included documentation of the MET call stand-down decision and associated decision-making elements, demographic and admission characteristics, and patient outcomes. We compared documentation of MET call stand-down decision-making with expert consensus on essential MET call stand-down decision-making elements. RESULTS: Key differences in the documentation of the essential MET call stand-down decision-making elements were that repeat MET patients had a higher proportion of care outcomes (post-MET call) documented (72%) than single MET patients (48.8%). Treatment decisions were documented over 75% of the time and an escalation plan was documented less than 50% of the time for both MET call patient groups. Repeat MET call patients were twice as likely to die in hospital (15.2% versus 7.6%, p = 0.01), had double the hospital length of stay (21 versus 10 days, p = 0.031), and were three times more likely to be discharged to rehabilitation services rather than home (28% versus 9.6%, p = 0.001). CONCLUSION: There were differences at the index MET call in documentation and outcomes between patients who required a single MET call and those who required repeat MET calls. Prospective observational research is recommended to better understand the MET call stand-down decision-making process at the patient bedside, environmental influences, and the impact on further patient deterioration.

Source: Australian Critical Care

DOI: 10.1016/j.aucc.2025.101310

Authors: Natalie A. Kondos, Jonathan Barrett, Jo McDonall, Tracey Bucknall

Institutions: Deakin University, The Alfred Hospital, Alfred Health

Language: English

Topic: Cardiac Arrest and Resuscitation

Subfield: Emergency Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $2,900