Patient Acuity Rating: a Tool to Prevent In-Hospital Cardiac Arrest (PAR)

The recruitment status of this study is unknown because the information has not been verified recently.
Verified March 2010 by University of Chicago.
Recruitment status was  Recruiting
Sponsor:
Collaborator:
Information provided by (Responsible Party):
University of Chicago
ClinicalTrials.gov Identifier:
NCT01082991
First received: March 5, 2010
Last updated: September 4, 2013
Last verified: March 2010

March 5, 2010
September 4, 2013
October 2009
December 2013   (final data collection date for primary outcome measure)
Mortality and cardiac arrest rates [ Time Frame: 15 months ] [ Designated as safety issue: Yes ]
Non-ICU ward inpatients will be randomized on admission to an RRT surveillance group or standard of care. Daily risk prediction scores will be collected for all non-ICU inpatients. Those with high scores, who have been randomized to the surveillance arm, will be included on a list of patients, updated daily, that the Rapid Response Team will receive, with instructions to evaluate and intervene, if required, without waiting for formal activation by the usual channels. Outcomes for these patients will be compared to those with comparable risk scores who were randomized to the control group.
Same as current
Complete list of historical versions of study NCT01082991 on ClinicalTrials.gov Archive Site
  • Length of stay [ Time Frame: 15 months ] [ Designated as safety issue: No ]
  • Cost [ Time Frame: 15 months ] [ Designated as safety issue: No ]
  • Time to ICU transfer [ Time Frame: 15 months ] [ Designated as safety issue: No ]
Same as current
Not Provided
Not Provided
 
Patient Acuity Rating: a Tool to Prevent In-Hospital Cardiac Arrest
Strategies to Predict and Prevent In-Hospital Cardiac Arrest

The purpose of this study is to evaluate the accuracy of medical personnel in their ability to predict the likelihood of non-intensive care (ICU), ward patients to clinically deteriorate (defined as a cardiac arrest, unplanned ICU transfer, or unexpected death)via the use of a clinical judgement-based tool designed for this study, Patient Acuity Rating (PAR), to predict short-term clinical deterioration. We will compare the ability of this tool to predict clinical deterioration compared to accepted physiology-based tools and tools combining judgment and physiology as well as other markers of deterioration such as physician order changes. We will compare the sensitivity, specificity and area under the curve of these combined models to the predictive models including only physiology or clinical judgment. We will assess the correlation between specific physician orders and patient deterioration to determine whether specific clinical activities, such as emergently obtained radiology exams, predict impending deterioration. We hypothesize that PAR will be a useful tool for predicting clinical deterioration across the institution and that it will have a higher average accuracy for predicting clinical deterioration in non-ICU inpatients within 24 hours than the physiology-based tools alone. We further hypothesize that a combined metric which includes both the PAR and the individual physiologic components that comprise physiologic tools will not significantly improve prediction over the PAR alone. We further propose to use PAR to prospectively risk stratify patients for preemptive evaluation by the Rapid Response Team. We hypothesize that intervening on high risk patients by preemptively activating the hospital's Rapid Response Team (to assess and treat patients as needed) will decrease cardiac arrest rates and mortality.

Not Provided
Interventional
Phase 0
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Prevention
Heart Arrest
Other: Preemptive Rapid Response Team intervention
Non-ICU inpatients will be randomized on admission to an RRT surveillance group or standard of care. Daily risk prediction scores will be collected for all non-ICU inpatients. Those with high scores, who have been randomized to the surveillance arm, will be included on a list of patients, updated daily, that the Rapid Response Team will receive, with instructions to evaluate and intervene, if required, without waiting for formal activation by the usual channels.
prevention
Intervention: Other: Preemptive Rapid Response Team intervention
Phillips AW, Yuen TC, Retzer E, Woodruff J, Arora V, Edelson DP. Supplementing cross-cover communication with the patient acuity rating. J Gen Intern Med. 2013 Mar;28(3):406-11. doi: 10.1007/s11606-012-2257-4. Epub 2012 Nov 6.

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruiting
20768
December 2013
December 2013   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • Non-ICU ward inpatients
  • PAR of 5 or above
  • Ages 18+ years

Exclusion Criteria:

  • ICU or outpatients
  • PAR of 4 or lower
  • Ages 17 years and under
Both
18 Years and older
No
Contact: Deborah L Walsh, MS, RN 7737028828 dwalsh@medicine.bsd.uchicago.edu
Contact: Dana P Edelson, MD, MS 773834-2191 dperes@medicine.bsd.uchicago.edu
United States
 
NCT01082991
15723A, 1K23HL097157-01
No
University of Chicago
University of Chicago
National Heart, Lung, and Blood Institute (NHLBI)
Principal Investigator: Dana P Edelson, MD, MS University of Chicago
University of Chicago
March 2010

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP