Use of a Medical Emergency Team Decreased Length of Stay in Severely Ill Medical Patients with Unscheduled ICU Admissions, But Not Costs and Mortality

1AGH, Pittsburgh, PA
2AGH, Pittsburgh, PA
3AGH, Pittsburgh, PA

Meeting: Hospital Medicine 2008, April 3-5, San Diego, Calif.

Abstract number: 14

Background:

Medical emergency teams (METs) have been developed to meet the growing needs of unstable hospitalized patients. The benefits of medical emergency teams have been reported as inconsistent in the literature, but METs may decrease length of stay, mortality, and unexpected ICU transfers.

Methods:

A retrospective analysis was done to evaluate the effects of a Medical emergency team in the first 6 months at our 714‐bed teaching hospital. Patient costs, outcomes, code calls, and length of stay (LOS) in unscheduled ICU transfers of medical patients were evaluated. Data were gathered from Data‐advantage software and chart review. Unscheduled ICU transfers for medical patients were compared for a similar 6‐month period from March 2005 to September 2005 (without a MET) and from March 2006 to September 2006 (with a MET).

Results:

Total number of admissions at our hospital for each 6‐month period were 14,689 in 2005 and 14,487 in 2006. There were 206 unexpected ICU transfers in 2005 and 249 unexpected ICU transfers in 2006. The proportion of deaths did not differ significantly between 2005 and 2006. In 2005, 168 unscheduled ICU transfers survived to discharge, and in 2006, 195 survived to discharge. There was no differences between the 2005 and 2006 groups in total patient costs/case, ICU costs/case, LOS, or ICU LOS. Further analysis of severity groups was done. In the severely ill patients (severity 3) who survived to discharge, there was a decrease in overall LOS in 2006 compared with that in 2005 (11.8 ± 6.9 vs. 16.3 ± 8.4, P = .02) and in ICU LOS in 2006 compared with that in 2005 (3.4 ± 2.7 vs. 3.9 ± 3.0, P = .047). There were no LOS or cost differences in the other severity groups. There was an overall 37% decrease in cardiac arrests in 2006. There was a mean of 12.2 MET calls/1000 discharges.

Conclusions:

This study evaluated the effects of the first 6 months of a MET team. Overall, there was a decrease in cardiac arrests but no change in overall mortality or unexpected ICU transfers. The medical patients who survived to discharge after the MET had no difference in cost per case. In the most severely ill patients who survived to discharge, there was a decrease in overall LOS and ICU LOS. The MET team appears to decrease LOS but not overall costs of severely ill medical patients who are unexpectedly transferred to the ICU and survive. Other significant benefits may only be seen after the MET has increased utilization.

Author Disclosure:

M. Cratty, none; H. Manyam, none; J. Kolojei, none.

To cite this abstract:

Cratty M, Manyam H, Kolodziej J. Use of a Medical Emergency Team Decreased Length of Stay in Severely Ill Medical Patients with Unscheduled ICU Admissions, But Not Costs and Mortality. Abstract published at Hospital Medicine 2008, April 3-5, San Diego, Calif. Abstract 14. Journal of Hospital Medicine. 2008; 3 (suppl 1). https://www.shmabstracts.com/abstract/use-of-a-medical-emergency-team-decreased-length-of-stay-in-severely-ill-medical-patients-with-unscheduled-icu-admissions-but-not-costs-and-mortality/. Accessed September 22, 2019.

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