ABSTRACT
This chapter explains about an innovative Australian patient safety system, designed by clinicians and refined through 2 decades of endeavor and experimentation. In the early 1990s, clinicians at the Liverpool Hospital, in Sydney, Australia, designed a system to help colleagues identify deteriorating patients earlier using defined criteria, and responded with a medical emergency team (MET) comprised of experienced clinicians from the intensive care unit (ICU). Australia had signaled a significant change to the silos of clinical team practice. It was clear that ICU expertise could be delivered quickly and effectively across unit boundaries, but there were still obstacles to implementing the MET concept across the whole health system. The MET-rapid response systems (RRS)-Between the Flags (BtF) success was created around a real patient safety problem. For entrenched organizational and historical reasons, patients were managed in organizational silos, within clinical disciplines—medicine and surgery, cardiology and orthopaedics.
