None listed
Conditions
Brief summary
Delays in escalation of care (EOC) can have serious consequences for patient safety and patient outcomes. While initiating a Medical Emergency Team (MET) call is a relatively smooth process, there are no defined behaviours surrounding pre-MET conversations. Even with well-established protocols, clinicians are reported to experience factors that inhibit initiation of EOC conversations. Research has identified key barriers to initiating EOC conversations as: fear of hierarchy, respondents explaining away or dismissing concerns, and poor risk awareness or skills. The purpose of this project is to address some of the barriers involved in EOC conversations prior to a MET call. To do this, an intervention that provides clinicians with training on the expectations of the ‘initiator’ and the ‘responder’ during an escalation conversation (in the form of a ‘choose-your-own-adventure’ training video) will be trialled at Austin Health. The training will be evaluated using pre- and post-intervention questionnaires on clinicians’ knowledge, confidence, and reluctance to escalate patient care, and experience sampling will be employed to examine clinicians’ experiences of EOC conversations during the trial period.
Interventions
The intervention consists of a short interactive training video completed as a one-off training session, lasting approximately 10 minutes. The training is designed to improve escalation of care conversations between clinicians by exposing each participant to a series of pre-Medical Emergency Team (MET) conversations and scenarios that enable them to practice identifying specific pre-MET communication skills and navigate common challenges. The training takes the form of a choose-your-own adventur
The intervention consists of a short interactive training video completed as a one-off training session, lasting approximately 10 minutes. The training is designed to improve escalation of care conversations between clinicians by exposing each participant to a series of pre-Medical Emergency Team (MET) conversations and scenarios that enable them to practice identifying specific pre-MET communication skills and navigate common challenges. The training takes the form of a choose-your-own adventure video to engage and immerse the viewer and to enable computer-generated feedback on their learning via different outcomes and lessons associated with the choices made at each decision point. The scenarios were developed specifically for this study, with input from key stakeholders, including from four public hospitals in Victoria (Eastern Health, Austin Health, The Alfred, and Royal Melbourne hospitals). The video will take every participant through five core scenarios related to the escalation of care process, designed to elicit a key communication principle central to appropriate escalation of care (in the same order). The themes of these five scenarios are: i) effective communication of critical information between team members, ii) obtaining the right information before escalating care, iii) ensuring communication is clear, concise, and structured, iv) speaking up and discussing clinical concerns as the arise, and v) respectful, closed-loop communication. A participant questionnaire will be used to monitor adherence to the intervention, and up to two email reminders to complete the training will be sent to participants over a one-week period.
Sponsors
Monash University
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Educational / counselling / training
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Clinicians of all age groups who work at the recruitment sites during the trial period and are potentially involved in escalation of care conversations through their work are eligible to participate, including nursing staff, doctors, and allied health professionals.
Exclusion criteria
No further exclusion criteria were required following recruitment.
Outcome results
None listed