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

  • Penny D. McCarthy
    Affiliations
    Deakin University, School of Nursing and Midwifery, 1 Gheringhap Street, Geelong, Australia

    Centre for Quality and Patient Safety Research – Eastern Health Partnership, Level 2, 5 Arnold St, Box Hill, Victoria, Australia

    Eastern Health, Arnold Street, Box Hill, Victoria, Australia
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  • Maryann Street
    Correspondence
    Corresponding author at: Centre for Quality and Patient Safety Research – Eastern Health Partnership, Level 2, 5 Arnold St, Box Hill, Victoria, Australia. Tel.: +61 429 876 434.
    Affiliations
    Deakin University, School of Nursing and Midwifery, 1 Gheringhap Street, Geelong, Australia

    Centre for Quality and Patient Safety Research – Eastern Health Partnership, Level 2, 5 Arnold St, Box Hill, Victoria, Australia

    Deakin University, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, 1 Gheringhap St, Geelong, Victoria, Australia
    Search for articles by this author
  • Stephanie K. Sprogis
    Affiliations
    Deakin University, School of Nursing and Midwifery, 1 Gheringhap Street, Geelong, Australia

    Centre for Quality and Patient Safety Research – Eastern Health Partnership, Level 2, 5 Arnold St, Box Hill, Victoria, Australia

    Deakin University, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, 1 Gheringhap St, Geelong, Victoria, Australia
    Search for articles by this author
  • Julie Considine
    Affiliations
    Deakin University, School of Nursing and Midwifery, 1 Gheringhap Street, Geelong, Australia

    Centre for Quality and Patient Safety Research – Eastern Health Partnership, Level 2, 5 Arnold St, Box Hill, Victoria, Australia

    Deakin University, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, 1 Gheringhap St, Geelong, Victoria, Australia
    Search for articles by this author
Published:February 14, 2022DOI:https://doi.org/10.1016/j.aucc.2021.12.005

      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

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