Impact of Non-technical Skills Training on Performance and Effectiveness of a Medical Emergency Team (IMPACT)

This study is currently recruiting participants. (see Contacts and Locations)
Verified September 2015 by Lyell McEwin Hospital
Information provided by (Responsible Party):
Dr Richard Chalwin, Lyell McEwin Hospital Identifier:
First received: March 4, 2012
Last updated: September 2, 2015
Last verified: September 2015
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
Hospital Rapid Response Team
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

Resource links provided by NLM:

Further study details as provided by Lyell McEwin Hospital:

Primary Outcome Measures:
  • 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 ]

Secondary Outcome Measures:
  • 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: July 2014
Estimated Study Completion Date: August 2019
Estimated Primary Completion Date: August 2018 (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.


Ages Eligible for Study:   16 Years and older   (Child, Adult, Senior)
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
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 identifier: NCT01551160

Contact: Richard Chalwin, FCICM +61882820890
Contact: Josette Wood, BN +61881829000

Australia, South Australia
Lyell McEwin Hospital Recruiting
Elizabeth Vale, South Australia, Australia, 5112
Contact: Richard Chalwin, FCICM    +61882820890   
Principal Investigator: Richard Chalwin, FCICM         
Sponsors and Collaborators
Lyell McEwin Hospital
Principal Investigator: Richard Chalwin, FCICM Lyell McEwin Hospital
  More Information

Responsible Party: Dr Richard Chalwin, Principal Investigator, Lyell McEwin Hospital Identifier: NCT01551160     History of Changes
Other Study ID Numbers: RPC1001 
Study First Received: March 4, 2012
Last Updated: September 2, 2015
Health Authority: Australia: Human Research Ethics Committee

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

Additional relevant MeSH terms:
Disease Attributes
Pathologic Processes processed this record on August 23, 2016