Impact of Non-technical Skills Training on Performance and Effectiveness of a Medical Emergency Team (IMPACT)
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Purpose
The purpose of this study is to ascertain the effect of implementing non-technical skills training (NTST) to members of a hospital medical emergency team (MET) on individual and team performance, and overall impact on patient outcomes.
| Condition | Intervention | Phase |
|---|---|---|
|
Medical Staff Non-technical Skills |
Other: Non-technical skills training |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Double Blind (Subject, Caregiver, Outcomes Assessor) Primary Purpose: Prevention |
| Official Title: | Impact of Non-technical Skills Training on Performance and Effectiveness of a Medical Emergency Team |
- Difference in MET performance of non-technical skills after implementation of NTST as assessed by qualitative scoring [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- Difference in incidence of efferent limb failure after implementation of NTST [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- Patient-centric: a. ICU length-of-stay b. mortality at ICU discharge c. hospital length-of-stay d. mortality at hospital discharge [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- MET service based: a. MET dose (i.e. number of MET calls per 1000 hospital in-patient admissions b. Incidence of unplanned ICU admission, cardiac arrest of death per 1000 hospital in-patient admissions. [ Time Frame: 1 year ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 600 |
| Study Start Date: | February 2013 |
| Estimated Study Completion Date: | March 2015 |
| Estimated Primary Completion Date: | February 2015 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Medical Emergency Team
Observation of Medical Emergency Team performance and recording of patient outcomes will occur in a before and after model
|
Other: Non-technical skills training
This will be delivered as a half-day session by experienced trainers
Other Name: Crisis Resource Management training
|
Detailed Description:
This will be a multi-partite quality improvement project run at the Lyell McEwin Hospital, a tertiary metropolitan hospital in Adelaide. The investigators plan to perform a retrospective audit of existing MET service data to establish baseline data. Then a period of prospective study will occur before and after delivery of NTST to members of the MET service. Team attendances will be independently observed for demonstration of non-technical skills and patients will be tracked during their hospital admission. A pilot observation will also be conducted to validate the observational assessment tool and measure inter-rater reliability between the investigators.
The primary outcomes will be 1) MET performance of non-technical skills as graded by a specifically developed qualitative assessment tool and 2) incidence of efferent limb failure as defined by a) requirement for a second MET attendance within 24 hours for the same calling criterion, b) unplanned admission to the Intensive Care Unit (ICU) within 24 hours of MET attendance, c) unexpected cardiac arrest and/or death within 24 hours of MET attendance. Secondary outcomes will include hospital and ICU length-of-stay, and vital status at hospital discharge. These will be used as a comparator between all periods of the project.
NTST will be delivered to MET members by the investigators in collaboration with a group of active instructors from QANTAS and the Royal Australian Air Force Reserves. Oversight will be provided by the hospital Safety and Quality Unit. The baseline audit will include 2000 patients and the observational stage of the study will enroll 700 patients, equally divided between the before- and after-NTST periods.
The investigators aim to demonstrate that training in non-technical skills improves MET service performance leading to a reduction in incidence of efferent limb failure. The anticipation is that this will then extrapolate to reductions in length-of-stay and mortality.
Eligibility| Ages Eligible for Study: | 16 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients or persons subject to Medical Emergency Team review
Exclusion Criteria:
- Patients in the ICU, Emergency Department or Operating Theatre suite
- Cancellation of the MET response prior to, or on arrival at, the location of activation
- Patients < 16 years of age
Contacts and Locations| Contact: Richard Chalwin, FCICM | +61882820890 | richard.chalwin@health.sa.gov.au |
| Contact: Josette Wood, BN | +61881829000 | josette.wood@health.sa.gov.au |
| Australia, South Australia | |
| Lyell McEwin Hospital | Not yet recruiting |
| Elizabeth Vale, South Australia, Australia, 5112 | |
| Contact: Richard Chalwin, FCICM +61882820890 richard.chalwin@health.sa.gov.au | |
| Principal Investigator: Richard Chalwin, FCICM | |
| Principal Investigator: | Richard Chalwin, FCICM | Lyell McEwin Hospital |
More Information
No publications provided
| Responsible Party: | Dr Richard Chalwin, Principal Investigator, Lyell McEwin Hospital |
| ClinicalTrials.gov Identifier: | NCT01551160 History of Changes |
| Other Study ID Numbers: | RPC1001 |
| Study First Received: | March 4, 2012 |
| Last Updated: | March 7, 2012 |
| Health Authority: | Australia: Lyell McEwin Hospital Safety and Quality Unit |
Keywords provided by Lyell McEwin Hospital:
|
Non-technical skills Crisis resource management Medical Emergency Team Rapid Response System |
Additional relevant MeSH terms:
|
Emergencies Disease Attributes Pathologic Processes |
ClinicalTrials.gov processed this record on June 18, 2013