PANEL DISCUSSION: OUTCOME DATA AND METS — QUESTIONS AND COMMENTS

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1. Comment: METS are just the implementation of good medicine. The fact that we need METS may reflect the inadequacy of training the residents, fellows and nurses.

2. Question: How is a physician's territorial behavior overcome? Are nurse/ respiratory therapist led METS protocol drive? When are they required to have physician input?

3. Question: In the RN/RT model, how often does the anesthesia or critical care physician come to the bedside?

4. Question: For and ICU-led METS model, is there 24 hr attending physician coverage? Is ICU coverage available for an ICU-led METS? Is there any data regarding what happens in the ICU when the team is responding to a MET call?

5. Question: When METS was first implemented, there was resistance. Now physicians make the MET totally responsible for all aspects of care. How do you achieve balance? How often are mistakes made and how are they dealt with?

6. Question: How do RN/RT lead METS implement treatments like lasix and IVF that routinely require a physician order? Are there protocols in place? Must the team contact an MD prior to starting these interventions?