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. 2023 Mar;36(2):254-261.
doi: 10.1016/j.aucc.2021.12.005. Epub 2022 Feb 14.

The patient experience of a medical emergency team review: A convergent mixed-methods study

Penny D McCarthy  1 , Maryann Street  2 , Stephanie K Sprogis  3 , Julie Considine  3
Affiliations

The patient experience of a medical emergency team review: A convergent mixed-methods study

Penny D McCarthy et al. Aust Crit Care. 2023 Mar.

Abstract

Aims: The aim of this study was to explore clinician-patient engagement during, and patient experience of, medical emergency team (MET) reviews.

Design: This study involved a convergent mixed-methods design.

Methods: This three-phase study was conducted at two hospitals of one Australian health service. Reviews by the MET were observed for clinician-patient engagement behaviours; medical records were audited to confirm patient demographics and clinical characteristics; and patients who received a MET review were interviewed. Quantitative data were analysed using descriptive statistics, and thematic analysis of qualitative interview data was conducted.

Results: In total, 26 MET reviews were observed for 22 patients (median age = 81.5 years and 68.2% females). Between 8 and 13 clinicians and other staff members were present during each review, with a total of 209 clinicians present during the 26 reviews. Clinicians were not observed to speak directly or indirectly to the patient about their care in 38.5% (n = 10/26) of the MET reviews, and 58.3% (n = 56/96) of interventions were performed without explanation. Four themes were identified from the interviews: An unexpected event; A lack of understanding; In good hands, and What happens next?

Conclusion: Clinician-patient engagement was infrequent during and after MET reviews. Patients experienced surprise from the sudden arrival of clinicians in their room and had poor levels of understanding about the review. However, most patients felt supported and safe. MET reviews are frequent safety-critical events, and this study identified the patient experience of these events. Clinicians should be aware that patients expressed they were surprised and shocked by the review and that an explanation of what was being done by the clinical team was rarely offered. These findings can be used to inform strategies to improve their patient-engagement behaviours and patient-centred care.

Keywords: Hospital care; Hospital rapid response team; Mixed-methods research; Nursing; Patient deterioration; Patient-centred care; Professional–patient relations; Rapid response system.

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