药品内部和外部的应急响应小组结构精良，脱颖而出。,The Journal of Trauma and Acute Care Surgery

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药品内部和外部的应急响应小组结构精良，脱颖而出。
The Journal of Trauma and Acute Care Surgery ( IF 2.9 ) Pub Date : 2019-01-01 , DOI: 10.1097/ta.0000000000002073
Joseph Fernandez-Moure ₁ , Jose L Pascual , Niels D Martin , Holly Rodgers , Lewis J Kaplan

Affiliation

医疗应急小组（MERT）遍布住院医院的各个护理机构。除了无处不在的快速反应团队的兴起以外，许多医院中目前的MERT还涉及创伤，中风，心肌梗塞和败血症。鉴于成员，领导能力和功能千差万别的团队众多，因此，对MERT的结构进行适当的审查，以确定改进的机会。由于非医学ERTs早于MERT发生并且在多个学科中都相似，因此非医学ERTs提供了一个标准来比较和审查MERT的设计和功能。非医学ERTs旨在利用经过全面培训并致力于该领域的团队成员，其技能是定期更新，领导力与独特技能相关联，而不是基于等级排名；每次部署结束时，活动都会立即进行审查，并且团队将继续在团队部署之间协同工作。紧急情况下的医疗应急小组通常将受训人员纳入不一起训练的团队中，他们不专注于需要利用的学科，而是根据到达时间或等级来领导，通常在远离团队的时间进行检查行动; 团队在每次活动后迅速分散，并且通常不会在团队激活之间继续合作。ERT和MERT之间的这些差异可能会妨碍MERT在发病率和死亡率减轻方面取得成功。弥合已发现差距的易于部署的方法包括专门的高级实践提供者（APP）团队领导，减少受训的MERT领导，同时保持参与，专业的救援队和团队间的整合培训。医学和非医学领域的应急响应团队虽然有相似之处，但在结构，职能，成员，角色和绩效评估上缺乏一致性。可能需要对医疗应急小组的结构进行重新设计，使其包含非医疗ERT的有益元素，以改善患者的预后并减少救援实践和团队功能的变化。

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Emergency response teams in and outside of medicine-structurally crafted to be worlds apart.

Medical emergency response teams (MERTs) are widespread throughout inpatient hospital care facilities. Besides the rise of the ubiquitous rapid response team, current MERTs span trauma, stroke, myocardial infarction, and sepsis in many hospitals. Given the multiplicity of teams with widely varying membership, leadership, and functionality, the structure of MERTs is appropriate to review to determine opportunities for improvement. Since nonmedical ERTs predate MERT genesis and are similar across multiple disciplines, nonmedical ERTs provide a standard against which to compare and review MERT design and function.Nonmedical ERTs are crafted to leverage team members who are fully trained and dedicated to that domain, whose skills are regularly updated, with leadership tied to unique skill sets rather than based on hierarchical rank; activity is immediately reviewed at the conclusion of each deployment and teams continue to work together between team deployments. Medical emergency response teams, in sharp contradistinction, often incorporate trainees into teams that do not train together, are not focused on the discipline required to be leveraged, are led based on arrival time or hierarchy, and are usually reviewed at a time remote from team action; teams rapidly disperse after each activity and generally do not continue to work together in between team activations. These differences between ERTs and MERTs may impede MERT success with regard to morbidity and mortality mitigation. Readily deployable approaches to bridge identified gaps include dedicated Advanced Practice Provider (APP) team leadership, reductions in trainee MERT leadership while preserving participation, discipline-dedicated rescue teams, and interteam integration training.Emergency response teams in medical and nonmedical domains share parallels yet lack congruency in structure, function, membership, roles, and performance evaluation. Medical emergency response team structural redesign may be warranted to embrace the beneficial elements of nonmedical ERTs to improve patient outcome and reduce variation in rescue practices and team functionality.

更新日期：2019-11-01

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