Overview

This trial has been completed.

Condition hospital rapid response team
Treatment a communication and team-working intervention
Sponsor Lyell McEwin Hospital
Collaborator University of Adelaide
Start date July 2014
End date July 2016
Trial size 1500 participants
Trial identifier NCT01551160, RPC1001

Summary

Patients in hospital can have unexpected clinical emergencies. When this occurs the Medical Emergency Team (MET) are called with the intention of resolving the problem. Previous investigations have found that patients who have more than one call during their admission have worse outcomes than patients who only have one call. But it has not been established why.

The aim of this research will be to examine these repeated calls and why patients subject to them go on to have worse outcomes. A predictive model will be developed to identify potential sources of risk. One potential source is poor communication between health care providers. An intervention to improve communication around MET calls may provide benefit to patients and improve outcomes.

United States No locations recruiting
Other Countries No locations recruiting

Study Design

Endpoint classification safety/efficacy study
Intervention model single group assignment
Masking open label
Primary purpose health services research
Arm
(Experimental)
A communication and team-working initiative
a communication and team-working intervention
Medical Emergency Team (MET) briefings and formalised handover between MET staff and patient care teams

Primary Outcomes

Measure
Multiple Medical Emergency Team calls per patient admission
time frame: Measured at time of hospital discharge

Secondary Outcomes

Measure
Mortality
time frame: At time of hospital discharge
Mortality
time frame: At completion of Medical Emergency Team call
ICU admission rate
time frame: At completion of Medical Emergency Team call
ICU interventions
time frame: At completion of Medical Emergency Team call

Eligibility Criteria

Male or female participants at least 18 years old.

Inclusions - Medical Emergency Team (MET) calls Exclusion Criteria: - Cancellation of the MET response prior to, or on arrival at, the location of activation - Calls to patients < 18 years of age

Additional Information

Official title Impact of a Communication and Team-working Intervention on Performance and Effectiveness of a Medical Emergency Team
Principal investigator Richard Chalwin, FCICM
Description This investigation will comprise a mixed methods, before-and-after study. The particulars are: Format: 1. Before intervention 1. Analysis of retrospective MET activity and patient outcome data 2. Surveying of staff for attitudes and perceptions of MET calls 2. Intervention 1. Twice-daily MET briefing meetings 2. Formalised handover process for MET calls resulting in patients remaining in their current clinical area 3. After intervention 1. Analysis of prospective MET activity and patient outcome data 2. Surveying of staff for attitudes and perceptions of MET calls Setting: Lyell McEwin Hospital, a 300 bed, university-affiliated, tertiary, metropolitan hospital located in Adelaide, South Australia. It has comprehensive in-patient medical and surgical services including a Level 3 Intensive Care Unit. Subjects: 1. Patients - adult in-patients attended by the MET during the study period. This will include patients attended more than once during an admission, as all calls will be a separate datapoint. It is also possible for patients to have more than one admission during the study period, so each admission will be considered discretely. 2. Staff - members of the hospital MET and ward staff that may call the MET. The MET composition is an ICU doctor, ICU nurse, medical registrar, intern and hospital manager. Due to rostering demands, this team is supplied from a pool of staff within each of the representative departments (approximately 10 ICU doctors, 30 ICU nurses, 30 medicine registrars, 36 interns and 8 duty managers). Data Collection: 1. Characteristics and Outcomes 1. Per-hospital admission data includes: age, gender, admission diagnosis, admission type, length of stay and mortality 2. Per-MET call data includes: reason for call, location, duration of call, interventions performed, disposition and mortality 2. Perceptions and Attitudes 1. Ward staff question including around interactions with MET, involvement during MET calls, experience of repeat calling and reasons for repeat calling 2. MET questions including around interactions with ward staff, involvement of ward staff during calls and resolution of calls.
Trial information was received from ClinicalTrials.gov and was last updated in November 2016.
Information provided to ClinicalTrials.gov by Lyell McEwin Hospital.