The new Department of Resuscitation at UAB Hospital’s has created a Medical Emergency Team (MET) that will bring critical care to the bedside when an urgent, life-threatening situation arises in a non-
critical care area of the hospital. Team members trained in a new simulation center are expected to help set a new standard for national health-care delivery, department directors say.

From left to right, Jason Keenum, Bete Craig, Andrew  Edwards, Jennifer Davis and Bendy Love demonstrate their skills as Medical Emergency Team members in the Simulation Center. Davis and Edwards are co-principal investigators on a grant provided by the UAB Health Systems Foundation General Endowment Fund to improve patient care through simulation training.

“The goal is to provide the resources needed quickly and get the patient stabilized,” says Jennifer Davis, M.D., co-medical director of the department.

“There is literature that shows hospitals can have a significant decrease in in-hospital cardiopulmonary arrest, unexpected ICU admissions or readmissions and a decrease in the absolute number of non-DNR deaths by implementing MET teams,” Davis says. “If we can move in more quickly on these patients, we can reduce the overall hospital mortality.”

Andrew Edwards, M.D., co-medical director, said each team includes a physician, two registered nurses, a respiratory therapist and a pharmacist, each of whom will receive specialized training. This team will provide service to the hospital 24 hours a day, seven days a week. “At the end of the day, we believe this will greatly enhance patient safety,” says Edwards.

Nurses primarily will be the ones activating the MET. They will use several indicators, including changes in heart rate, blood pressure, levels of oxygen saturation, decreased level of consciousness and even gut instinct or concern about their patient.

“The team can initiate resuscitation efforts and stabilize the situation with the goal of preventing a patient from developing full cardiac arrest,” said Mike Moran, nurse manager.

Other lead members of the department include Wanda Sandlin, administrative director of Medical Nursing, and Martha Farley, nurse educator.

Simulation Center
The Department of Resuscitation will provide training for team members and offer continuing medical education (CME) classes for health-care professionals in its simulation center. Davis and Edwards are co-principal investigators on a two-year, $250,000 grant provided by the UAB Health Systems Foundation General Endowment Fund to improve patient care through simulation training.

The center uses two, state-of-the-art, human-patient simulator manikins to help train staff in resuscitation techniques, assessment of disease processes and invasive procedures such as placement of central lines and chest tubes and difficult airway management. The manikins also can be programmed to simulate disease processes such as sepsis, pneumonia, bleeding ulcers and will respond to trainee interventions.

Cameras enable the teams to capture their training on video and follow up with discussion and review of the events in the debriefing room.

“You can see firsthand where you need to improve, either as a team or individually,” Davis says. “The debriefing session is probably the most valuable education tool in the whole process.”

Expanded uses
The simulation center also can be used to train house staff and many other groups on campus, Davis says.

“We’re going to extend it initially to house staff, primarily focusing on trying to reduce complications from procedures,” she says. “We hope to extend it to the medical school, as well. We believe it can benefit medical students, nurses, house staff and even attending physicians who want to practice skills they may not have used in a while.”

Davis says the center also will invite the community for CME courses and possibly train paramedics and firefighters.

“The resources of the hospital and expertise of the staff are expected to set a national standard for health-care delivery. We believe this department and the simulation center will help us achieve these goals,” says Davis.