PANEL DISCUSSION: MEASUREMENT— QUESTIONS AND COMMENTS

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1. Question: If the patient does not warrant ICU admission, is the primary team able to implement the recommendation made by the MET?

2. Question: If a patient requires ICU admission, and no beds are available, can the MET care for the patient in the current location until the patient is transferred? Do we have study data?

3. Question: Are there any systematic changes that can be implemented to improve the nurses ability to monitor and act upon the criteria indicating clinical intervention?

4. Question: How can the concern of the nurses for a patients behavior, without knowledge of the underlying etiology, be factored into a METS call?

5. Question: How can the presence of an on-call team and METS be reconciled?

6. Comment: Oftentimes, there may be a delay in recognizing clinical deterioration because it is not a nurse, but a technical or assistant is getting the vitals. There may be a one hour delay before the vitals are seen. Secondly, the person getting the vitals may not recognize the warning signs because they have not been trained to think critically, or communicate clearly what they are thinking. It is therefore imperative that the medical team come to the bedside.

7. Question: How long is a typical MET response?