Abstract 19404: Effect of Medical Emergency Teams in Pediatric Hospitals on Hospital Mortality
Introduction: Medical emergency teams (METs) have been promoted as a strategy to reduce preventable hospital deaths. Studies of METs on hospital mortality have been limited to single center studies.
Hypothesis: METs in children’s hospitals reduce mortality
Methods: The Pediatric Health Information System (PHIS) contains data on annual mortality for freestanding children’s hospitals in the U.S. For each hospital, the year of MET implementation was determined, and annual mortality rates, risk-adjusted for case-mix severity for all admissions, were calculated for each year before and after MET implementation. A random slopes interrupted time series analysis was conducted to examine whether implementation of MET teams was associated with reduction in mortality rates compared to existing trends before implementation.
Results: Of 38 PHIS hospitals with mortality data before and after MET implementation, mean annual hospital admission volume was 15,854 (range: 6,684-33,024), and MET team implementation occurred between 2005 and 2013. The mean pre-intervention and post-intervention periods were 3.0 years (range: 0.9-4.7) and 7.4 years (range: 2.1-9.8), respectively. Within each hospital, annual mortality after MET implementation was not lower than expected based on pre-intervention mortality trends (all P>0.05). When the results of all 38 hospitals were pooled, there remained no difference between the predicted (6.33 deaths per 1000 admissions based on pre-intervention trends) and actual mortality rate (6.48 deaths per 1000 admissions; P=0.57) 5 years after MET implementation (Figure).
Conclusions: Implementation of METs in a large sample of pediatric hospitals in the U.S. was not associated with a reduction in hospital mortality beyond existing pre-intervention trends. This represents the largest study, to date, on the impact of METs on hospital mortality in children and suggests that additional strategies are needed to reduce in-hospital mortality.
Author Disclosures: S. Kutty: None. P. Jones: None. Q. Karels: None. N. Joseph: None. J. Spertus: None. P.S. Chan: None.
- © 2016 by American Heart Association, Inc.