Where deterioration drives improvement.
You know the sound. That high pitched beep-beep-beep of the nurse call system putting out a Medical Emergency alarm that slices through the ward’s relative calm and sends everyone’s pulse into orbit. For many clinicians, it’s the sound of something going wrong—of a patient who deteriorated, a system that faltered, a bad day getting worse.
But what if we’re misreading it? What if these rapid response calls and medical emergency responses aren’t the end of something… but the beginning?
In New South Wales, vital sign trending and early warning scores are often called “between the flags.” Like surf lifesaving, the flags are there to guide us to safety. In hospital, those flags are our observation charts: the yellow and red zones that quietly steer us towards early recognition and timely escalation. When a patient drifts outside the flags, the rapid response or medical emergency team is the rescue.
But a rescue—on the beach or in the ward—isn’t just a single clinical event. It’s a moment thick with information, teamwork, pressure, patterns, and insights. It’s one of the richest learning opportunities we have. We just don’t always treat it that way.
The Hot Debrief: Your Post-Event Power-Up
Once the patient is stabilised and the room starts to breathe again, the best learning window opens. It’s tiny—measured in minutes—and if we don’t grab it, the lessons evaporate into scattered comments in the tea room or a vague sense of “that felt messy.” This is exactly where the STOP5 model shines.
STOP5 is a quick, structured, five-minute debrief designed for the real world—fast, practical, and psychologically safe. It keeps the conversation focused on improvement, not blame, and helps the team walk away clearer and more connected than they arrived. Think of it as a reset button for performance and team culture.
S — Shared Understanding
“Let’s make sure we’re all on the same page. Can someone give us a quick run-through of what happened?”
This aligns everyone’s mental model and clears away assumptions, confusion, and fragmented memories of the event.T — Things That Went Well
“What worked for us today?”
Calling out the positives first matters. It reinforces good practice, boosts morale, and builds psychological safety—especially for junior staff.O — Opportunities to Improve
“What could we do better next time?”
This isn’t about finger-pointing. It’s about systems, teamwork, equipment, communication, and process.
Was access delayed? Was gear hard to find? Did roles get muddy? Did the call happen early enough?P — Points to Action
“What are our clear takeaways?”
This is where reflection becomes improvement. Identify concrete fixes: a daily trolley check, a communication tweak, a stock issue to escalate.
STOP5 is designed to be brief. The facilitator keeps it tight, closes by confirming actions, and makes sure people walk away feeling heard rather than drained.
It’s simple. It’s fast. It fits into real clinical life. Most importantly, it changes behaviour. Teams become more cohesive, escalation becomes easier, and performance under pressure improves. A five-minute conversation today can change the way your next medical emergency unfolds.
Every Call Is a Data Point
A Rapid Response System isn’t just the efferent arm—the people who sprint to the bedside. It’s also the afferent arm (early recognition) and the quality improvement arm. The QI arm is where the real magic happens.
Every call leaves behind clues about how the hospital is functioning. Every delay, every near miss, every brilliant save, every equipment issue—they’re all data points. When you treat them as such, patterns reveal themselves.
One study looked at paramedics trained with real-time CPR feedback devices. You’d expect gold-standard compressions with that kind of guidance. Instead, even with high-tech feedback, median depth sat at a too-shallow 1.7 inches. The takeaway isn’t “people don’t care”—it’s “people get overloaded.” In real time, clinicians are managing airway, access, drugs, communication, leadership, crowd control… and somewhere on the monitor there’s a tiny green bar yelling “push deeper!”
Data like this is priceless. It tells us training needs to focus not just on what to do, but on how to use feedback and manage cognitive load in the heat of a crisis.
Building a Learning Health System
When you collect and review MET data systematically, you create a hospital that learns continuously. Best practice stops being something you hope for—it starts becoming something you build into the system. Not all learning needs to wait for a meeting room. Every MET call is a teaching moment if you treat it like one.
Thinking Out Loud
One of the most powerful teaching tools is simply narrating your clinical reasoning: “Okay—tachycardic, hypotensive, saturations dropping. I’m thinking sepsis. Let’s get fluids going and draw cultures.” It demystifies critical care. It upskills the ward team in real time. And it builds confidence like nothing else.
Proactive rounding—visiting wards to review high-risk patients before a call—isn’t universally proven to reduce mortality, but the qualitative benefits are enormous. When a ward nurse knows the ICU liaison team, trusts them, and feels respected, they call earlier and without hesitation. One study nailed it: proactive rounding works because “it gives the ward staff confidence to call.”
And Please—No Blame
Nothing shuts down an RRS faster than judgment. If the MET team arrives with even a whiff of condescension, that ward will hesitate next time. And hesitation is dangerous. A supportive, educational tone isn’t optional. It’s a safety requirement.
Training for the Trenches
Knowing the guidelines and actually running a chaotic resus are two different sports. When things unravel, it’s rarely clinical knowledge—it’s human factors. Simulation is the bridge between “I know the algorithm” and “I can lead a room full of anxious humans at 3am.”
Simulation lets teams rehearse the stuff that really makes or breaks a emergency response:
- leadership
- communication
- speaking up
- role clarity
- situational awareness
- closed-loop communication
It’s the only safe place to practise the messy realities of a real deterioration event. And it’s where a group of individuals becomes a team.
Recognise, Respond, Reflect
A MET call isn’t a failure. It’s a highly compressed, high-stakes, multi-layered learning experience. It’s a chance to:
- debrief immediately
- identify system gaps
- teach at the bedside
- refine communication
- improve equipment and processes
- feed meaningful data into your QI cycle
- build trust across teams
- shape the next response long before it happens