Triggers for emergency team activation: A multicenter assessment

Purpose: The purpose of the study was to examine triggers for emergency team activation in hospitals with or without a medical emergency team (MET) system. Materials and Methods: Within a cluster randomized controlled trial examining the effect of introducing a MET system, we recorded the triggers for emergency team activation. We compared the proportion and rate of such triggers in hospitals with or without a MET system and in relation to type of hospital, type of patient ward, and time of day. Results: In control hospitals, the most common trigger for emergency team activation was a decrease in Glasgow Coma Score by 2 or more points (45.6%), whereas in MET hospitals, it was the fact that staff members were "worried" or the call occurred despite the lack of a "specified reason" (39.3%). In particular, MET hospitals were 35 times more likely to make a call because of staff being "worried" about the patient (14.1% vs 0.4%, P <.001). Control hospitals were also significantly more likely to call an emergency team because of a deteriorating respiratory (P =.003) or pulse (P <.001) rate, more calls had at least 3 triggers for activation (20.8% vs 10.2%, P =.036), and the average number of triggers per call was significantly higher (P =.013). Nonmetropolitan hospitals were more likely to call an