Improving the utilization of medical crisis teams (Condition C) at an urban tertiary care hospital

Mohamed I Foraida, Michael A DeVita, R Scott Braithwaite, Susan A Stuart, Maria Mori Brooks, Richard L Simmons
Journal of Critical Care 2003, 18 (2): 87-94

PURPOSE: Serious clinical deterioration precedes most cardiopulmonary arrests, and there is evidence that organized responses to this deterioration may prevent a substantial proportion of in-hospital deaths. We aimed to increase the utilization of our medical crisis response team (Condition C) to impact this source of mortality.

METHODS: We have examined the change in numbers of Condition Cs and the main alternative response strategy (sequential stat pages) after the implementation of 4 strategies to increase Condition C utilization: (1) immediate reviews of all sequential STAT pages, (2) feedback to caregivers responsible for delays in Condition C activation, (3) creation of objective criteria for invoking a crisis response, and (4) dissemination of objective criteria through posting in units, e-mail, and in-service oral presentations.

RESULTS: Over a 3-year period, interventions were followed by increased use of organized responses to medical crises (Condition Cs) and decreased numbers of disorganized responses (sequential STAT pages). The interventions that involved objective definition and dissemination of criteria for initiating the Condition C response were followed by 19.2 more Condition Cs monthly (95% confidence interval [CI], 12.1-26.3; P<0001) and 5.7 fewer sequential STAT pages monthly (95% CI, 3.2-8.2). The interventions that involved giving feedback to medical personnel based on review of their care were not associated with changes in the measures.

CONCLUSION: Utilization of an important patient safety measure may be increased by focused interventions at an urban tertiary care hospital.

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