ANZCTR - Registration

Please note the ANZCTR will be unattended from Friday 20 December 2024 for the holidays. The Registry will re-open on Tuesday 7 January 2025. Submissions and updates will not be processed during that time.

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Trial registered on ANZCTR

Registration number

ACTRN12620000357954

Ethics application status

Approved

Date submitted

27/02/2020

Date registered

12/03/2020

Date last updated

15/09/2022

Date data sharing statement initially provided

12/03/2020

Type of registration

Prospectively registered

Titles & IDs

Public title

The Critical Care Outreach Consultant pilot audit

Scientific title

Effect of a critical care outreach consultant on the outcomes of at-risk and deteriorating hospitalized patients

Secondary ID [1]

Nil known

Universal Trial Number (UTN)

Trial acronym

Linked study record

Health condition

Health condition(s) or problem(s) studied:

In-hospital at-risk and deteriorating ward patients

Condition category

Condition code

Public Health

Health service research

Intervention/exposure

Study type

Observational

Patient registry

False

Target follow-up duration

Target follow-up type

Description of intervention(s) / exposure

Introduction of an intensive care specialist to provide pre-emptive review of emergency department patients who may require intensive care unit admission and to be a senior decision maker to provide oversight of ward-based medical emergency team (MET) reviews. This will involve clinical review, medical imaging and blood tests as dictated by the intensive care clinicians as part of usual care. The frequency of review will vary between patients. It will vary from a single review to multiple reviews in a single day. The duration of follow-up will also be governed by the treating clinicians. This may vary from one day to daily reviews until hospital discharge. The frequency of review will be dictated by the patients perceived risk status and response to treatment.

Intervention code [1]

Not applicable

Comparator / control treatment

Timeliness of admission of Emergency Department patients and Medical Emergency Team call to the intensive care unit during their admission to the Austin Hospital during April 2019 - March 2020..

Control group

Historical

Outcomes

Primary outcome [1]

Timeliness of admission of Emergency Department patients to the intensive care unit. This will be determined by measuring the interval between the date and time of patient triage in the emergency department and the date and time of ICU admission. Both of these dates and times are routinely collected in a hospital administrative system called Medtrack.

Timepoint [1]

Time between Emergency Department triage and admission to the intensive care unit

Primary outcome [2]

Timeliness of admission of Medical Emergency Team call patients to the intensive care unit.
This will be determined by measuring the interval between the date and time of patient triage in the emergency department and the date and time of ICU admission. Both of these dates and times are routinely collected in a hospital administrative system called Medtrack.

Timepoint [2]

Time between first Medical Emergency Team call and admission to the intensive care unit

Secondary outcome [1]

Acute Physiology and Chronic Health III Score as an assessment of severity of illness

Timepoint [1]

On admission to intensive care unit admission for the patient's index hospital admission

Secondary outcome [2]

Proportion of patients who have two or more medical emergency team calls. on medical emergency team calls are routinely collected on an electronic system called Risk-Man VHIMS. The proportion of patients who have two or more medical emergency team calls will be measured by dividing the number of patients who have more than one medical emergency team call review during the same admission (multiple medical emergency team patients) by the total number of patients who have received a medical emergency team call.

Timepoint [2]

Within index hospital admission

Secondary outcome [3]

Length of hospital admission. This will be assessed by the difference between the date and time of hospital discharge and the date and time of hospital admission

Timepoint [3]

Duration in days of hospital admission for the index hospital admission

Secondary outcome [4]

Length of stay in the intensive care unit. This will be assessed by the difference between the date and time of Intensive care discharge and the date and time of Intensive care admission.

Timepoint [4]

Duration in days of intensive care unit admission for the index hospital admission

Secondary outcome [5]

Intensive care unit mortality

Timepoint [5]

Death of a patient occuring in the intensive care unit during the index hospital admission

Secondary outcome [6]

Hospital mortality

Timepoint [6]

Death of a patient occuring in the hospital during the index hospital admission

Secondary outcome [7]

Medical emergency team call activations per 1000 admissions.
Medical record review.

Timepoint [7]

During hospital admission for the study period.

Eligibility

Key inclusion criteria

Patients aged greater than or equal to 18 years of age
Admitted to the intensive care unit from the emergency department
Admitted to the intensive care unit following medical emergency team call

Minimum age

18 Years

Maximum age

No limit

Sex

Both males and females

Can healthy volunteers participate?

Key exclusion criteria

Did not get admitted to the intensive care unit from the emergency department or following a medical emergency team call,

Study design

Purpose

Natural history

Duration

Longitudinal

Selection

Defined population

Timing

Both

Statistical methods / analysis

Comparison of proportions with chi-squared
Comparison of median (IQR) timelines with Mann-Whitney U test
Analysis will occur for the period where the intervention is applied
Interrupted time-series analysis will also be conducted to take into account the effects of secular trends or changes over time that were occurring independent of the introduction of the critical care outreach consultant role

Recruitment

Recruitment status

Recruiting

Date of first participant enrolment

Anticipated

20/04/2020

Actual

20/04/2020

Date of last participant enrolment

Anticipated

Actual

Date of last data collection

Anticipated

Actual

Sample size

Target

520

Accrual to date

Final

Recruitment in Australia

Recruitment state(s)

VIC

Recruitment hospital [1]

Austin Health - Austin Hospital - Heidelberg

Recruitment postcode(s) [1]

3084 - Heidelberg

Recruitment postcode(s) [2]

3084 - Banyule

Funding & Sponsors

Funding source category [1]

Hospital

Name [1]

Austin Hospital

Address [1]

145 Studley Road
Heidelberg
Victoria 3084

Country [1]

Australia

Primary sponsor type

Hospital

Name

Austin Health

Address

145 Studley Road
Heidelberg
Victoria 3084

Country

Australia

Secondary sponsor category [1]

Individual

Name [1]

Associate Professor Daryl Jones

Address [1]

Department of Intensive Care
Austin Hospital
145 Studley Road
Heidelberg
Victoria 3084

Country [1]

Australia

Ethics approval

Ethics application status

Approved

Ethics committee name [1]

Austin Health Human Research Ethics Committee

Ethics committee address [1]

Office for Research
Austin Health
Level 8, Harold Stokes Building
145 Studley Road
Heidelberg
Victoria 3084

Ethics committee country [1]

Australia

Date submitted for ethics approval [1]

14/02/2020

Approval date [1]

05/03/2020

Ethics approval number [1]

Audit/20/Austin/23

Summary

Brief summary

The Austin hospital is introducing a critical care outreach consultant to oversee the assessment and management of patients outside the ICU at the acute campus 

This commenced April 20th 2020, and has now received permanent funding. 

The schedule for this role has been developed by ICU staff and has been approved by the Medical Director of the Department of Intensive Care, Austin Hospital.

Patients will not be randomised as part of this new role, which will be considered as routine care. 
The role has been introduced to: 
1. Improve the timeliness of referral and admission from the emergency department (ED)
2. Oversee the assessment and review of patients seen by the Medical Emergency Team MET) and Intensive Care nurse consultants (ICNC)
3. Coordinate referrals to the ICU from all sources (internal and external)
4. Assist with the stabilization and admission of unplanned ICU admissions in some circumstances 

The deteriorating patient committee is expecting the outcomes of this role to be audited as part of the PDSA (plan – do – study – act) cycle.

The purpose of this audit is to outline the nature of the data that will be collected as part of this audit.

Trial website

Trial related presentations / publications

Public notes

Contacts

Principal investigator

Name

A/Prof Daryl Jones

Address

Department of Intensive Care
Level 2, Austin Tower
Austin Hospital
145 Studley Road
Heidelberg
Victoria 3084

Country

Australia

Phone

+61 3 9496 5057

Fax

+61 3 9496 3932

daryl.jones@austin.org.au

Contact person for public queries

Name

Dr Glenn Eastwood

Address

Department of Intensive Care
Level 2, Austin Tower
Austin Hospital
145 Studley Road
Heidelberg
Victoria 3084

Country

Australia

Phone

+61 3 9496 4835

Fax

+61 3 9496 3932

glenn.eastwood@austin.org.au

Contact person for scientific queries

Name

Daryl Jones

Address

Department of Intensive Care
Level 2, Austin Tower
Austin Hospital
145 Studley Road
Heidelberg
Victoria 3084

Country

Australia

Phone

+61 3 9496 5057

Fax

+61 3 9496 3932

daryl.jones@austin.org.au

Data sharing statement

Will individual participant data (IPD) for this trial be available (including data dictionaries)?

No/undecided IPD sharing reason/comment

This is confidential information of patients admitted to Austin Health and information is obtained under the 'audit' framework.

What supporting documents are/will be available?

No Supporting Document Provided

Results publications and other study-related documents

Documents added manually

Current Study Results

No documents have been uploaded by study researchers.

Update to Study Results

Doc. No.	Type	Is Peer Reviewed?	DOI	Citations or Other Details	Attachment
5277	Study results article	Yes	https://doi.org/10.51893/2021.3.OA1.	Austin Health Critical Care Outreach Physician (CC... [More Details]

Documents added automatically

No additional documents have been identified.

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