Impact of Non-technical Skills Training on Performance and Effectiveness of a Medical Emergency Team (IMPACT)
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.
Hospital Rapid Response Team
Other: Non-technical skills training
|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 ]
|Study Start Date:||July 2014|
|Estimated Study Completion Date:||February 2018|
|Estimated Primary Completion Date:||August 2017 (Final data collection date for primary outcome measure)|
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
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.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01551160
|Contact: Richard Chalwin, FCICMfirstname.lastname@example.org|
|Contact: Josette Wood, BNemail@example.com|
|Australia, South Australia|
|Lyell McEwin Hospital||Recruiting|
|Elizabeth Vale, South Australia, Australia, 5112|
|Contact: Richard Chalwin, FCICM +61882820890 firstname.lastname@example.org|
|Principal Investigator: Richard Chalwin, FCICM|
|Principal Investigator:||Richard Chalwin, FCICM||Lyell McEwin Hospital|