Hospital Rapid Response TeamIMPACTNCT01551160
Impact of a Communication and Team-working Intervention on Performance and Effectiveness of a Medical Emergency Team
A study testing A communication and team-working intervention in people with Hospital Rapid Response Team, run by Lyell McEwin Hospital at 1 site in Australia.
Trial summary
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… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Hospital Rapid Response Team
- What is being tested?
- A communication and team-working intervention
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 1,500 participants
- Where
- 1 siteAustralia
- Study dates
- Jul 2014to Sep 2016
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
None listed.
Who cannot join
- Cancellation of the MET response prior to, or on arrival at, the location of activation
- Calls to patients < 18 years of age
Trial locations and contacts
1 site in 1 country.
About this study
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.
Read the detailed description
This investigation will comprise a mixed methods, before-and-after study. The particulars are:
Format:
- Before intervention
- Analysis of retrospective MET activity and patient outcome data
- Surveying of staff for attitudes and perceptions of MET calls
- Intervention
- Twice-daily MET briefing meetings
- Formalised handover process for MET calls resulting in patients remaining in their current clinical area
- After intervention
- Analysis of prospective MET activity and patient outcome data
- 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:
- 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.
- 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:
- Characteristics and Outcomes
- Per-hospital admission data includes: age, gender, admission diagnosis, admission type, length of stay and mortality
- Per-MET call data includes: reason for call, location, duration of call, interventions performed, disposition and mortality
- Perceptions and Attitudes
- Ward staff question including around interactions with MET, involvement during MET calls, experience of repeat calling and reasons for repeat calling
- MET questions including around interactions with ward staff, involvement of ward staff during calls and resolution of calls.
- Conditions
- Hospital Rapid Response Team
- Being tested
- A communication and team-working intervention
- Keywords
- Non-technical skills, Crisis resource management, Medical Emergency Team, Rapid Response Team
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
A communication and team-working interventionOther
Medical Emergency Team (MET) briefings and formalised handover between MET staff and patient care teams
| Study group | Role | What they receive |
|---|---|---|
| Medical Emergency Team | Experimental | A communication and team-working initiative Receives: Other: A communication and team-working intervention |
What is being measured
The primary outcome is the main question the study is designed to answer.
Multiple Medical Emergency Team calls per patient admission
Measured: Measured at time of hospital discharge
Secondary outcomes (4)
Mortality
Measured: At time of hospital discharge
Mortality
Measured: At completion of Medical Emergency Team call
ICU admission rate
Measured: At completion of Medical Emergency Team call
ICU interventions
Measured: At completion of Medical Emergency Team call
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Mar 2012 (estimated)
- Study startJul 2014
- Primary completionJul 2016
- Study completionSep 2016
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Hospital Rapid Response TeamStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 1,500 participants (actual)
Sponsor and investigators
- Lead sponsor
- Lyell McEwin Hospital
- Sponsor type
- Other government
- Collaborators
- University of Adelaide
- Responsible party
- Principal investigator, Dr Richard Chalwin, Lyell McEwin Hospital
- Investigators
- Richard Chalwin, FCICM, Principal investigator, Lyell McEwin Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01551160
- Sponsor's protocol ID
- RPC1001
- Acronym
- IMPACT
- Status last verified
- Nov 2016
- First submitted
- 4 Mar 2012
- Last updated
- 25 Nov 2016
- Results posted
- No
- Data monitoring committee
- No
- Individual data sharing
- No
Publications
Chalwin RP, Flabouris A. Utility and assessment of non-technical skills for rapid response systems and medical emergency teams. Intern Med J. 2013 Sep;43(9):962-9. doi: 10.1111/imj.12172.
PubMed 23611153Chalwin R, Giles L, Salter A, Kapitola K, Karnon J. Re-designing a rapid response system: effect on staff experiences and perceptions of rapid response team calls. BMC Health Serv Res. 2020 May 29;20(1):480. doi: 10.1186/s12913-020-05260-z.
PubMed 32471422
Study at a glance
From the registry record, last updated by the sponsor on 25 Nov 2016. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Impact of a Communication and Team-working Intervention on Performance and Effectiveness of a Medical Emergency Team
- ClinicalTrials.gov ID
- NCT01551160
- Acronym / sponsor ID
- IMPACT / RPC1001
- Conditions
- Hospital Rapid Response Team
- Keywords
- Non-technical skills, Crisis resource management, Medical Emergency Team, Rapid Response Team
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 1,500 participants (actual)
- Lead sponsor
- Lyell McEwin HospitalOther government
- Collaborators
- University of Adelaide
- Study start
- Jul 2014
- Primary completion
- Jul 2016 (actual)
- Study completion
- Sep 2016 (actual)
- First posted
- 12 Mar 2012 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Detailed description
This investigation will comprise a mixed methods, before-and-after study. The particulars are:
Format:
- Before intervention
- Analysis of retrospective MET activity and patient outcome data
- Surveying of staff for attitudes and perceptions of MET calls
- Intervention
- Twice-daily MET briefing meetings
- Formalised handover process for MET calls resulting in patients remaining in their current clinical area
- After intervention
- Analysis of prospective MET activity and patient outcome data
- 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:
- 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.
- 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:
- Characteristics and Outcomes
- Per-hospital admission data includes: age, gender, admission diagnosis, admission type, length of stay and mortality
- Per-MET call data includes: reason for call, location, duration of call, interventions performed, disposition and mortality
- Perceptions and Attitudes
- Ward staff question including around interactions with MET, involvement during MET calls, experience of repeat calling and reasons for repeat calling
- MET questions including around interactions with ward staff, involvement of ward staff during calls and resolution of calls.
Study design
- Primary purpose
- Health services research
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Medical Emergency Team | Experimental | Other: A communication and team-working interventionA communication and team-working initiative |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (0 listed)
Key exclusion criteria (2 listed)
- Cancellation of the MET response prior to, or on arrival at, the location of activation
- Calls to patients < 18 years of age
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| A communication and team-working interventionMedical Emergency Team (MET) briefings and formalised handover between MET staff and patient care teams | Other | Medical Emergency Team |
Primary outcome
Multiple Medical Emergency Team calls per patient admission
Time frame: Measured at time of hospital discharge
4 secondary outcomes
Mortality
Time frame: At time of hospital discharge
Mortality
Time frame: At completion of Medical Emergency Team call
ICU admission rate
Time frame: At completion of Medical Emergency Team call
ICU interventions
Time frame: At completion of Medical Emergency Team call
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 25 Nov 2016.
- Background: PubMed 23611153Chalwin RP, Flabouris A. Utility and assessment of non-technical skills for rapid response systems and medical emergency teams. Intern Med J. 2013 Sep;43(9):962-9. doi: 10.1111/imj.12172.
- Derived from this study: PubMed 32471422Chalwin R, Giles L, Salter A, Kapitola K, Karnon J. Re-designing a rapid response system: effect on staff experiences and perceptions of rapid response team calls. BMC Health Serv Res. 2020 May 29;20(1):480. doi: 10.1186/s12913-020-05260-z.
- Individual participant dataSharing planned: No
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Prospective Cohort Study of Rapid Response Team
Hospital Medical Emergency Team, Medicine, Emergency
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Richard Chalwin, FCICM principal investigator
Lyell McEwin Hospital
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing A communication and team-working intervention in people with Hospital Rapid Response Team, run by Lyell McEwin Hospital at 1 site in Australia.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 0 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 25 Nov 2016. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Australia. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Multiple Medical Emergency Team calls per patient admission (time frame: Measured at time of hospital discharge). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01551160, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 Nov 2016.