A simulation based pilot of a new medical evaluation team for external hospital emergencies

Tuesday, May 15
09:45 - 10:45
Location: The Gate, Atrium 3rd Level

Background: Multiple studies have determined the clinical impact and effectiveness of rapid response or medical evaluation teams that evaluate patients admitted to non-ICU wards with a change in clinical status prior to respiratory or cardiac arrest. In meta-analyses, adult hospital rapid response teams have been demonstrated to be associated with a decreased hospital mortality and a decreased rate of cardiopulmonary arrests occurring outside of the ICU.1 Single center pediatric hospital studies have yielded similar results.2 Simulation has previously been demonstrated as a methodology for assessing rapid response teams.3 In the United States, legislation mandates that all persons on hospital property who request medical attention, be evaluated by hospital staff. At Seattle Children’s Hospital, these individuals were previously evaluated by the code blue team. However due to a high number of activations, a new response team was designed.

Research Question: The aim of this study is determine if a new medical evaluation team can safely and rapidly respond to medical emergencies occurring outside the main hospital building.

Methodology: The new medical evaluation team was designed to include one emergency department (ED) fellow, two ED nurses and two security guards. None of these individuals previously participated in the code blue team. The proposed team structure was trialed for two consecutive simulated cases to quantify response time, to pilot the new team structure and to evaluate new equipment. Time metrics were collected and a debriefing session was held after each scenario.

Results: Time metrics included time to team assembly, arrival on scene and return to ED with patient. Metrics identified improved response time for running versus driving to the patient and the optimal route for patient transport. Participants identified communication strategies for efficient handoff, best practices for communication amongst team members, coordination with the ED and the need for a standard location naming convention. Medical supply backpack contents were evaluated and revised. The maneuverability, safety and overall usability of the new stretcher was assessed.

Discussion/Conclusions: The new medical evaluation team could safely and rapidly respond to medical emergencies located outside of the main hospital building. Participants identified the need for reliable, secure communication amongst team members and with the ED. A structured simulation was effective for piloting the new team structure, measuring key time metrics, gathering feedback and critically evaluating new equipment.





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