ANZCTR - Registration

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Trial registered on ANZCTR

Registration number

ACTRN12614000951651

Ethics application status

Approved

Date submitted

28/08/2014

Date registered

4/09/2014

Date last updated

15/06/2021

Date data sharing statement initially provided

15/06/2021

Date results provided

15/06/2021

Type of registration

Prospectively registered

Titles & IDs

Public title

Characteristics and Outcomes of Medical Emergency Team (MET) Calls in New Zealand - a Prospective Observational Study

Scientific title

A multicentre prospective observational study of all patients who require a Medical Emergency Team review (or local equivalent) in New Zealand hospitals over a 2 week period to identify the characteristics & outcome of this population.

Secondary ID [1]

Nil

Universal Trial Number (UTN)

U1111-1160-9956

Trial acronym

NZMET

Linked study record

Health condition

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

Medical Emergency Teams

Deteriorating hospitalised patients

Condition category

Condition code

Respiratory

Other respiratory disorders / diseases

Surgery

Other surgery

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

Observational study of patients who require Medical Emergency Team (MET) review in 11 New Zealand hospitals over a 2 week period.

Data collected will include demographics of these patients, their physiological data (vital signs) that necessitated the MET review, who called for & who attended the MET, interventions performed by the MET, any decisions regarding further care (including end-of-life care) made by the MET as a result of their attendance and a review of the patient's status at 30 days post-MET.

Intervention code [1]

Not applicable

Comparator / control treatment

N/A

Control group

Uncontrolled

Outcomes

Primary outcome [1]

Variation in MET calling patterns between NZ hospitals by comparing data from each

Timepoint [1]

2 week period of all MET calls

Primary outcome [2]

Trigger(s) leading to activation of the MET within each NZ hospital by comparing data from each

Timepoint [2]

2 week period of all MET calls

Secondary outcome [1]

End-of-life care or limitation of medical treatment decisions that may occur after review by a MET

Timepoint [1]

2 week period of all MET calls

Secondary outcome [2]

30 day mortality of all patients who receive a MET call

Timepoint [2]

30 days post MET call

Eligibility

Key inclusion criteria

All patients who receive a MET call at one of the study centres during the 2 week observational period

Minimum age

No limit

Maximum age

No limit

Sex

Both males and females

Can healthy volunteers participate?

Key exclusion criteria

None

Study design

Purpose

Natural history

Duration

Cross-sectional

Selection

Defined population

Timing

Prospective

Statistical methods / analysis

Recruitment

Recruitment status

Completed

Date of first participant enrolment

Anticipated

3/11/2014

Actual

13/10/2014

Date of last participant enrolment

Anticipated

17/11/2014

Actual

30/11/2014

Date of last data collection

Anticipated

Actual

30/11/2014

Sample size

Target

300

Accrual to date

Final

351

Recruitment outside Australia

Country [1]

New Zealand

State/province [1]

Funding & Sponsors

Funding source category [1]

Self funded/Unfunded

Name [1]

Address [1]

Country [1]

Primary sponsor type

Individual

Name

Alex Psirides

Address

Intensive Care Unit
Wellington Regional Hospital
Riddiford Street
Newtown
Wellington
6021

Country

New Zealand

Secondary sponsor category [1]

Individual

Name [1]

Anne Pedersen

Address [1]

Intensive Care Unit
Wellington Regional Hospital
Riddiford Street
Newtown
Wellington
6021

Country [1]

New Zealand

Ethics approval

Ethics application status

Approved

Ethics committee name [1]

HDEC New Zealand

Ethics committee address [1]

Ministry of Health
No 1 The Terrace
PO Box 5013
Wellington
6145

Ethics committee country [1]

New Zealand

Date submitted for ethics approval [1]

29/08/2014

Approval date [1]

16/09/2014

Ethics approval number [1]

14/CEN/143

Summary

Brief summary

Patients admitted to hospital wards have increasingly complex conditions and a growing number of co-morbidities. Medical emergency teams (METs) have been introduced into hospitals to identify, review and treat acutely deteriorating ward patients in an attempt to reduce cardiac arrests, serious adverse events and unplanned admissions to the intensive care unit.

To date there have been limited studies examining the use of the MET model of care in New Zealand. Knott and others conducted a retrospective cohort study in Wellington, New Zealand. Review by the hospital’s MET was associated with a doubling of documentation of advanced care directives (from 32 before to 64% after MET review).

Psirides and others conducted a cross-sectional study of recognition and response systems in NZ public hospitals during October 2011. They found considerable variation in the thresholds for activation of RRTs between hospitals.

Pedersen and others have described the models and activities of critical care outreach teams in New Zealand hospitals & have shown considerable variance in the type of work conducted by such teams with variable involvement in responding to deteriorating ward patients.

Finally, Drower and co-workers conducted a before and after study to examine the effect of introducing a new vital sign chart, an escalation policy and an expanded response by the cardiac arrest team on the incidence of cardiac arrests in Waikato hospital. They found that this combined approach was associated with a reduction in the incidence of cardiac arrests from 4.67 during 2009– 2010 and 2.91 during 2010–2011 (mean difference of 1.77, 95%CI 0.59–2.94). This study was limited by the presence of a large amount of missing information about emergency calls.

To date no study has assessed the characteristics and outcomes of patients subject to MET review in New Zealand.

We plan to conduct a multi-centre prospective observational study in New Zealand to assess the characteristics and outcomes of Medical Emergency Team (MET) (or equivalent) calls occurring over a two week period. The term ‘MET’ is used to refer to any hospital system that can be activated to review deteriorating hospital inpatients based on either pre-determined physiological criteria or staff concern.

Specifically, we will assess:
1. The variation in the number of MET calls per week between hospitals

2. The timing of these calls – both in relation to time of day, day of week, and in relation to hospital admission.

3. The trigger(s) leading to activation of the MET activation

4. The immediate outcome of the patient at the conclusion of the MET call (cardiac arrest, other death during call, remained on ward, transferred to another ward, admitted to HDU / ICU, other)

5. Details of limitations of medical therapy immediately before and after the call (NFR, for full care, for limited care).

6. Disposition at hospital discharge (home, rehab, other hospital, place other than home, deceased) or whether remained in hospital 30 days after termination of study.

Trial website

Trial related presentations / publications

Public notes

Contacts

Principal investigator

Name

Dr Alex Psirides

Address

Intensive Care Unit
Wellington Regional Hospital
Riddiford Street
Newtown
Wellington
6021

Country

New Zealand

Phone

+6443855999

Fax

[email protected]

Contact person for public queries

Name

Alex Psirides

Address

Intensive Care Unit
Wellington Regional Hospital
Riddiford Street
Newtown
Wellington
6021

Country

New Zealand

Phone

+6443855999

Fax

[email protected]

Contact person for scientific queries

Name

Alex Psirides

Address

Intensive Care Unit
Wellington Regional Hospital
Riddiford Street
Newtown
Wellington
6021

Country

New Zealand

Phone

+6443855999

Fax

[email protected]

Data sharing statement

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

No/undecided IPD sharing reason/comment

What supporting documents are/will be available?

No Supporting Document Provided

Results publications and other study-related documents

Documents added manually

No documents have been uploaded by study researchers.

Documents added automatically

Source	Title	Year of Publication	DOI
Dimensions AI	Rapid Response Team activation in New Zealand hospitals—a multicentre prospective observational study	2016	https://doi.org/10.1177/0310057x1604400314

N.B. These documents automatically identified may not have been verified by the study sponsor.

Trial Review

Documents added manually

Documents added automatically