PANEL DISCUSSION: CHANGING HOSPITAL CULTURE— QUESTIONS AND COMMENTS

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1. Question: METS has decreased LOS in older patients. Does data from the US and UK and Australia reveal the same?

2. Comment: There are now fewer hospital beds in all countries save Belgium.

3. Question: Physicians need to be more direct about telling patients and families that they are dying. Has MET activation criteria been used to screen patients on a general ward to determine who is a at risk of deteriorating?

4. Question: Are there methods other than SBAR to train staff and physicians in critical thinking?

5. Question: Hospital patients are older, have more severe illnesses but have decreases in mortality and LOS. However, we are discharging patients from the ICU that have the same acuity as in the past. Why so?

6. Question: Community-based physicians are trying to implement METS in the face of a shortage of critical care physicians, and lack of support from the medical staff. How is the skeptical medical staff convinced of the value of METS in face of the MERIT study results?

7. Comment: Distributed sensor networks may be the next big development in patient monitoring systems.