University of Western Australia, Perth, WA.
Med J Aust. 2011 Jun 6;194(11):596-8. doi: 10.5694/j.1326-5377.2011.tb03113.x.
Medical Assessment Units (MAUs) provide an opportunity for multidisciplinary staff to manage recently admitted acutely unwell patients with complex medical illnesses. We propose concerted development of robust mechanisms for identifying and managing patients whose condition is unstable as they move through hospital departments. Track, trigger and response (TTR) systems (eg, medical emergency team calls and early warning scores) have been introduced to hospital practice, but evidence for their effectiveness is, so far, incomplete. The current variation in TTR systems within and between hospitals impairs intersite comparisons. A range of outcome measures, including risk of physiological deterioration, mortality and projected hospital length of stay, could be usefully investigated by future intersite collaborative research. More deliberate, systematic, evidence-based design of "response" in TTR systems may help in identifying patients who need early attention from skilled medical staff. We need more uniform TTR systems, more research on TTR systems and more multisite research; MAUs are ideally situated to address this important area.
医疗评估单元（MAU）为多学科工作人员提供了一个机会，以管理最近因复杂内科疾病而入院的急性不适患者。我们建议共同制定强有力的机制，以识别和管理在医院科室之间移动时病情不稳定的患者。跟踪、触发和响应（TTR）系统（例如，医疗急救小组的电话和早期预警评分）已被引入医院实践，但迄今为止，其有效性的证据并不完整。目前，医院内部和之间的 TTR 系统存在差异，这影响了站点间的比较。一系列的结果指标，包括生理恶化、死亡率和预计住院时间的风险，都可以通过未来的站点间合作研究进行有用的调查。更慎重、系统地、基于证据的 TTR 系统“响应”设计可能有助于识别需要医护人员早期关注的患者。我们需要更统一的 TTR 系统、更多关于 TTR 系统的研究以及更多的多站点研究；MAU 非常适合解决这一重要领域。
