1) The ICU at Reinier de Graaf Hospital in Delft works to ensure patient safety through protocols, guidelines, and an intensivist-led closed format. 2) To further increase safety outside the ICU, the hospital introduced a Medical Emergency Team (MET) in 2004 composed of ICU professionals who provide rapid response to patients experiencing medical emergencies. 3) Evidence on the impact of METs is inconclusive but most studies show benefits to patient outcomes and mortality reduction. The hospital believes early detection and treatment of deteriorating patients can prevent serious adverse events.

1. Patient safety in Reinier de Graaf Hospital Delft: the role of the ICU Peter Tangkau, MD intensivist chairman Task Force “ implementing critical care response systems”

7. THE PROBLEM: IN-HOSPITAL MEDICAL EMERGENCY

13. Part of serious adverse events were avoidable!

19. Evidence for medical emergency teams: inconclusive

21. Do we need evidence? Let’s start studies

23. Procedure “early recognition and treatment of patients with an in hospital medical emergency ”

25. the “success formula” of the SIT RDGG

28. Rapid Response System: “ the Dutch approach”

35. Afferent limb: event detection warning signals MEWS: modified early warning score

36. How to measure vital signs?

40. The Methodist Hospital in Houston, Texas has two robots that can be controlled remotely by a doctor to navigate wards and communicate with patients and staff on wards where rapid access to expert advice is critical. The blue and black robots, nicknamed MURDOC (Mobile Unit Robot Doctor) and ROHAS (Remote Operated Health Assessment System), travel up to 2 mph, can be easily steered down a hallway or alongside a patient bed, and are equipped with infrared sensors to help the physician navigate. The robots allow physicians, patients, nurses and other staff to “virtually” interact and talk at a moment’s notice. Is this our future?

41. No: the patient needs a doctor at her bedside

42. Doctors need scientists (and vice versa) to help them in their clinical practice

43. … ...To prevent this

44. Let’s start with respiration

45. Questions? You can always call or visit us! [email_address]