ANZICS S&Q 2014 - RRT: John Santamaria on RRT Crises and accountability from an ICU directors perspective
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John Santamaria on RRT Crises and accountability from an ICU directors perspective. Presented at the ANZICS S&Q Conference 2014 on Rapid Response Teams.
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ANZICS S&Q 2014 - RRT: John Santamaria on RRT Crises and accountability from an ICU directors perspective
- 1. Crises and Accountability ICU Director Perspective John Santamaria
- 2. Introduction • MERIT Study • Phases of Medical Emergency Service • The MET Child • The MET Adolescent • The MET Adult
- 3. The MET Child • The “Calls” • Define the “TEAM” • Medical Registrar, ICU Registrar, ICU Nurse • Define the Calling Criteria • Set up the Database
- 4. The MET Child • Establish a feedback system • Calls, Reports, Analyses • Educate the Hospital • Clinical, allied health, administrative • CRISIS • Continue or Stop : Resistance
- 5. The MET Adolescent • Calling Criteria • The Team • The Database • The Feedback
- 6. The MET Adolescent • Calling Criteria • The Team • The Database • The Feedback
- 7. The MET Adolescent • Calling Criteria • The Team • The Database • The Feedback
- 8. The MET Adolescent • Data Analysis • Oxygen problems, Seizure management • Education • New staff about MET • Training of registrars & nurses
- 9. The MET Adult • The Team • Expanding work needs more staff (after hours) • Simultaneous calls • Location of calls • Legal responsibility
- 10. The MET Adult • Calling Criteria • Resuscitation status • parent unit calls
- 11. The MET Adult • Calling Criteria • Resuscitation status, parent unit calls • Feedback • Team members • Data Collection • National MET database
- 12. The MET Adult • Education • Team members • Ward staff • Simulation • Audit & Research
- 13. The MET Adult • Crises • Multiple calls • External situations • Who is responsible for care? Airways?
- 14. The MET Adult • Care & Legal accountabilities • Who has the best airway skills in hospital? • Who is best looking after a deteriorating patient?
- 15. Standard 9 • How to implement recommendations
- 16. Extended Monitoring • Incorporate other data sources into monitoring • Abnormal pathology tests • Bed side monitoring (HR, BP, RR, SpO2, CO2)
- 17. The Next Phase Old MET Unit? MET 25% Optimal Arrest 50% Death