Medical Emergency Teams (MET) and Rapid Response Teams (RRT) are groups of health care professionals that may be assembled emergently in response to patient deterioration. They are part of a Rapid Response System (RRS) that can identify and protect patients in crisis, and prevent future crises. A number of authors have now identified that potentially lethal patient deteriorations occur frequently in hospitalized patients, although individual patients have a low probability of having one of these high risk events. When the crisis occurs, the patient is often identified late and as a result may be under treated. The Afferent Limb of the Rapid Response System is the component that finds (detects) patients with physiologic deteriorations and which have insufficient resources on hand to manage them effectively. The proper methodology for the afferent limb is unresolved. Much work has been done to predict risk using Modified Early Warning Scores (MEWS) and similar models. Other programs prefer a single parameter (such as a high respiratory rate) to trigger a team response. There is a healthy debate regarding which is more effective in identifying at risk patients. Another debate relates to whether intermittent monitoring (by vital sign checks) is sufficient to identify all at risk patients. Some safety experts are advocating instead a continuous electronic monitoring system for all or some patients to avoid missing opportunities to rescue patients in distress. There are data on these points, and our group believes it is important to bring together researchers from around the world to compare and analyze data, and make recommendations for future research and clinical practice. We intend to hold a consensus conference on the Afferent Limb of the Rapid Response System on two days in May, 2008. It will build upon our success at the First International Consensus Conference on Rapid Response Systems in 2005, the findings of which were reported in 2006 in Critical Care Medicine. In addition to bringing together the leading researchers in the field, we have invited stakeholders to be represented among the participants for the conference. The Joint Commission for Accreditation of Healthcare Organizations (JCAHO), American College of Chest Physicians, American Hospital Association, American Association of Critical Care Nurses, the American Association of Medical Colleges, and the Veterans Administration all are strongly considering participating in and supporting this important conference. The primary purpose of this conference is to review impact on patient safety of identifying early deteriorations in patient clinical status. We will do this by reviewing the literature to date, and discussing key questions pertaining to this area. We intend to provide a map for future research and some guidance for clinical care. There will be three reporting methodologies to disseminate the findings. First, the investigators will make a presentation of the report at the Fourth International Conference on Rapid Response Systems which will immediately follow the consensus conference in Toronto. This conference is expected to have over 500 attendees. Second, the investigators will post the slide set on the conference's website: www.metconference.com. This website contains presentations from the first three international conferences. Third, the participants will write a manuscript for publication in a major peer review journal. ? ? ?
