Now Available: Final Rule for FDAAA 801 and NIH Policy on Clinical Trial Reporting

Impact of a Communication and Team-working Intervention on Performance and Effectiveness of a Medical Emergency Team (IMPACT)

This study has been completed.
Sponsor:
Collaborator:
University of Adelaide
Information provided by (Responsible Party):
Dr Richard Chalwin, Lyell McEwin Hospital
ClinicalTrials.gov Identifier:
NCT01551160
First received: March 4, 2012
Last updated: November 23, 2016
Last verified: November 2016
  Purpose

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.


Condition Intervention
Hospital Rapid Response Team
Other: A communication and team-working intervention

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Health Services Research
Official Title: Impact of a Communication and Team-working Intervention on Performance and Effectiveness of a Medical Emergency Team

Resource links provided by NLM:


Further study details as provided by Lyell McEwin Hospital:

Primary Outcome Measures:
  • Multiple Medical Emergency Team calls per patient admission [ Time Frame: Measured at time of hospital discharge ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Mortality [ Time Frame: At time of hospital discharge ] [ Designated as safety issue: Yes ]
  • Mortality [ Time Frame: At completion of Medical Emergency Team call ] [ Designated as safety issue: Yes ]
  • ICU admission rate [ Time Frame: At completion of Medical Emergency Team call ] [ Designated as safety issue: No ]
  • ICU interventions [ Time Frame: At completion of Medical Emergency Team call ] [ Designated as safety issue: No ]

Other Outcome Measures:
  • Perceptions of Interactions between Medical Emergency Team staff and patient care teams [ Time Frame: 1 year ] [ Designated as safety issue: No ]
    Both Medical Emergency Team staff and patient care teams will be surveyed separately


Enrollment: 1500
Study Start Date: July 2014
Study Completion Date: September 2016
Primary Completion Date: July 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Medical Emergency Team
A communication and team-working initiative
Other: A communication and team-working intervention
Medical Emergency Team (MET) briefings and formalised handover between MET staff and patient care teams

Detailed 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.
  Eligibility

Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

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
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01551160

Locations
Australia, South Australia
Lyell McEwin Hospital
Elizabeth Vale, South Australia, Australia, 5112
Sponsors and Collaborators
Lyell McEwin Hospital
University of Adelaide
Investigators
Principal Investigator: Richard Chalwin, FCICM Lyell McEwin Hospital
  More Information

Publications:
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: November 23, 2016
Health Authority: Australia: Human Research Ethics Committee
Individual Participant Data  
Plan to Share IPD: No

Keywords provided by Lyell McEwin Hospital:
Non-technical skills
Crisis resource management
Medical Emergency Team
Rapid Response Team

Additional relevant MeSH terms:
Emergencies
Disease Attributes
Pathologic Processes

ClinicalTrials.gov processed this record on December 07, 2016