- Missen, Karen, Porter, Joanne, Raymond, Anita, de Vent, Kerry, Larkins, Jo-Ann
- Authors: Missen, Karen , Porter, Joanne , Raymond, Anita , de Vent, Kerry , Larkins, Jo-Ann
- Date: 2018
- Type: Text , Journal article
- Relation: Collegian Vol. 25, no. 2 (2018), p. 157-161
- Full Text: false
- Reviewed:
- Description: Aims: To evaluate the impact of Acute Deterioration Detection System (ADDS) charts introduced to a regional healthcare service. Background: To assist health professionals in identifying essential elements for recognizing patient clinical deterioration, a national initiative introduced track and trigger observation charts, to hospitals in Australia. This study investigated whether the introduction of ADDS charts had an impact on the number of Medical Emergency Team (MET) and Code Blue activations at one regional healthcare service, according to their incident recording database. Method: A retrospective study of all Code Blue and MET activations was undertaken at a regional hospital, pre and post the introduction of ADDS charts in a two year period, June 2012 to June 2014. Results: There was a significant increase in MET activations from 5.91 to 11.27 per 1000 admissions (p < 0.01) after the implementation of ADDS charts. There was also an unexplained non-significant increase from 0.50 to 0.88 per 1000 admissions in the activations of Code Blue during this period (p = 0.05). It was also found that ADDS charts did not overly influence the activation criteria for calling a MET/Code Blue, except for an increase in reports of high heart rate and a decrease in the use of the criteria ‘worried’. Conclusion: The introduction of ADDS charts has provided health professionals with a clear track and trigger set of criteria, improving the detection of early signs of deterioration in patients. This study demonstrated an increase in activations as a result of the introduction of ADDS charts in one regional healthcare service.
- Cant, Robyn, Cooper, Simon J.
- Authors: Cant, Robyn , Cooper, Simon J.
- Date: 2014
- Type: Text , Journal article
- Relation: Resuscitation Vol. 85, no. (2014), p. 31-33
- Full Text: false
- Reviewed:
- Description: Medical emergency team performance including non-technical skills, is receiving increased attention due to the influences on patient safety. The Team Emergency Assessment Measure View the MathML source was developed to enable standardized performance assessment and structured team debriefing. From several studies, the View the MathML source has demonstrated a substantial body of normative data confirming its validity and reliability. This includes high uni-dimensional validity, significant subscale relationships between Teamwork and Leadership and between Teamwork and Task Management (p < 0.001), a Cronbach alpha of 0.92 and adequate construct validity. The tool has potential for team training to improve team's non-technical performance. Further testing is required in ‘real’ clinical settings.
- Cant, Robyn, Porter, Joanne, Cooper, Simon J., Roberts, Kate, Wilson, Ian, Gartside, Christopher
- Authors: Cant, Robyn , Porter, Joanne , Cooper, Simon J. , Roberts, Kate , Wilson, Ian , Gartside, Christopher
- Date: 2016
- Type: Text , Journal article
- Relation: EMA - Emergency Medicine Australasia Vol. 28, no. 6 (2016), p. 641-646
- Full Text: false
- Reviewed:
- Description: Objectives: This prospective descriptive study aimed to test the validity and feasibility of the Team Emergency Assessment Measure (TEAM™) for assessing real-world medical emergency teams' non-technical skills. Second, the present study aimed to explore the instrument's contribution to practice regarding teamwork and learning outcomes. Methods: Registered nurses (RNs) and medical staff (n = 104) in two hospital EDs in rural Victoria, Australia, participated. Over a 10 month period, the (TEAM™) instrument was completed by multiple clinicians at medical emergency episodes. Results: In 80 real-world medical emergency team resuscitation episodes (283 clinician assessments), non-technical skills ratings averaged 89% per episode (39 of a possible 44 points). Twenty-one episodes were rated in the lowest quartile (i.e. ≤37 points out of 44). Ratings differed by discipline, with significantly higher scores given by medical raters (mean: 41.1 ± 4.4) than RNs (38.7 ± 5.4) (P = 0.001). This difference occurred in the Leadership domain. The tool was reliable with Cronbach's alpha 0.78, high uni-dimensional validity and mean inter-item correlation of 0.45. Concurrent validity was confirmed by strong correlation between TEAM™ score and the awarded Global Rating (P < 0.001), with 38.4% of shared variance. RNs praised the instrument as it initiated staff reflection and debriefing discussions around performance improvement. Conclusion: Non-technical skills of medical emergency teams are known to often be suboptimal; however, average ratings of 89% were achieved in this real-world study. TEAM™ is a valid, reliable and easy to use tool, for both training and clinical settings, with benefits for team performance when used as an assessment and/or debriefing tool. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine
Patients’ experiences of acute deterioration and Medical Emergency Team (MET) encounter : a grounded theory study
- Authors: Chung, Catherine
- Date: 2021
- Type: Text , Thesis , PhD
- Full Text:
- Description: Globally, considerable effort has been made to ensure hospital patients whose clinical condition deteriorates receive timely and appropriate care. Research suggests that hospitals have increasing numbers of patients who are more likely to become seriously ill during their admission due to complex problems. Recently, patient experience has been recognised as a means of assessing healthcare delivery with healthcare services across the world gathering patient experience or satisfaction data. Acute deterioration is unique and complex for all involved. However, little is known about this experience from the patient’s perspective. The purpose of this study was to generate theory about processes patients engage in when experiencing acute deterioration and MET encounter. Also, the research aimed to recognise and explain the factors that mediate patients’ experiences. The findings of this study contribute to a growing body of knowledge that will improve patient care and practice guidelines for healthcare professionals. Underpinned by the theoretical framework of symbolic interactionism, grounded theory was employed for this study. From it ontological, epistemological, and methodological underpinnings, constructivist grounded theory was considered the most suitable approach. Using purposive sampling, in-depth semi-structured interviews were conducted with 27 patients across three Australian healthcare services. Data were collected over a 12-month period, between May 2018 – May 2019 and analysed using constant comparative analysis. The theoretical model ‘Unravelling a complex experience: contextualising patients’ experiences of acute clinical deterioration and Medical Emergency Team (MET) encounter’ emerged, offering a possible explanation of patients’ actions and processes. Most patients began their journeys feeling something was wrong which triggered emotional changes (experiencing changes-before the encounter). Patient experience was influenced by a combination of physical and psychological changes and a MET response (perceiving the reality - the encounter). After the MET encounter, some patients searched for deeper understandings about their illnesses and the events that occurred, whereas others managed without further reflection (reflecting on the event-after the encounter). Contextual conditions emerged influencing patients’ experiences with three broad mediating factors identified. Some participants identified that their acute deterioration and subsequent MET encounter was unexpected, and they perceived the nature of their illness (before their acute deterioration) as stable, based on what they had been told by medical staff (expectations and illness perception). Many participants acknowledged that their experience was dependent on the health care professionals who were caring for them at the time (relationship with the MET). Past experiences of illness and hospitalisation played an important role in participants’ abilities to conceptualise their experiences of acute deterioration and MET encounter (past experiences). These factors exerted a significant influence on participants’ experiences and helps to explain the differences between them. Unravelling a complex experience: Conceptualising patients’ experiences of acute deterioration and MET encounter offers a possible explanation of patients’ meanings, actions and processes when experiencing acute deterioration and MET encounter. The theory leads to recommendations that healthcare organisations gather data about patients’ experiences of acute deterioration and MET encounters, as these provide insights and opportunity to identify challenges that can be addressed.. Findings provide an explanatory framework for similar phenomena and increase awareness of patients’ experiences to ultimately inform health policy and improve patient care. The findings highlight the need for healthcare services to instigate strategies that support patients who have experienced acute deterioration. Further research could evaluate the effectiveness of implemented strategies.
- Description: Doctor of Philosophy
- Authors: Chung, Catherine
- Date: 2021
- Type: Text , Thesis , PhD
- Full Text:
- Description: Globally, considerable effort has been made to ensure hospital patients whose clinical condition deteriorates receive timely and appropriate care. Research suggests that hospitals have increasing numbers of patients who are more likely to become seriously ill during their admission due to complex problems. Recently, patient experience has been recognised as a means of assessing healthcare delivery with healthcare services across the world gathering patient experience or satisfaction data. Acute deterioration is unique and complex for all involved. However, little is known about this experience from the patient’s perspective. The purpose of this study was to generate theory about processes patients engage in when experiencing acute deterioration and MET encounter. Also, the research aimed to recognise and explain the factors that mediate patients’ experiences. The findings of this study contribute to a growing body of knowledge that will improve patient care and practice guidelines for healthcare professionals. Underpinned by the theoretical framework of symbolic interactionism, grounded theory was employed for this study. From it ontological, epistemological, and methodological underpinnings, constructivist grounded theory was considered the most suitable approach. Using purposive sampling, in-depth semi-structured interviews were conducted with 27 patients across three Australian healthcare services. Data were collected over a 12-month period, between May 2018 – May 2019 and analysed using constant comparative analysis. The theoretical model ‘Unravelling a complex experience: contextualising patients’ experiences of acute clinical deterioration and Medical Emergency Team (MET) encounter’ emerged, offering a possible explanation of patients’ actions and processes. Most patients began their journeys feeling something was wrong which triggered emotional changes (experiencing changes-before the encounter). Patient experience was influenced by a combination of physical and psychological changes and a MET response (perceiving the reality - the encounter). After the MET encounter, some patients searched for deeper understandings about their illnesses and the events that occurred, whereas others managed without further reflection (reflecting on the event-after the encounter). Contextual conditions emerged influencing patients’ experiences with three broad mediating factors identified. Some participants identified that their acute deterioration and subsequent MET encounter was unexpected, and they perceived the nature of their illness (before their acute deterioration) as stable, based on what they had been told by medical staff (expectations and illness perception). Many participants acknowledged that their experience was dependent on the health care professionals who were caring for them at the time (relationship with the MET). Past experiences of illness and hospitalisation played an important role in participants’ abilities to conceptualise their experiences of acute deterioration and MET encounter (past experiences). These factors exerted a significant influence on participants’ experiences and helps to explain the differences between them. Unravelling a complex experience: Conceptualising patients’ experiences of acute deterioration and MET encounter offers a possible explanation of patients’ meanings, actions and processes when experiencing acute deterioration and MET encounter. The theory leads to recommendations that healthcare organisations gather data about patients’ experiences of acute deterioration and MET encounters, as these provide insights and opportunity to identify challenges that can be addressed.. Findings provide an explanatory framework for similar phenomena and increase awareness of patients’ experiences to ultimately inform health policy and improve patient care. The findings highlight the need for healthcare services to instigate strategies that support patients who have experienced acute deterioration. Further research could evaluate the effectiveness of implemented strategies.
- Description: Doctor of Philosophy
Contextual factors influencing patients' experiences of acute deterioration and medical emergency team (MET) encounter : a grounded theory study
- Chung, Catherine, McKenna, Lisa, Cooper, Simon
- Authors: Chung, Catherine , McKenna, Lisa , Cooper, Simon
- Date: 2022
- Type: Text , Journal article
- Relation: Journal of Advanced Nursing Vol. 78, no. 12 (2022), p. 4062-4070
- Full Text:
- Reviewed:
- Description: Aim: This paper explores the personal, social and structural factors that influence patients' experiences of acute deterioration and medical emergency team (MET) encounter. Background: Patient experience is recognized as a means of assessing healthcare delivery with a positive experience being linked to high-quality healthcare, improved patient safety and reduced length of stay. The experience of acute deterioration is unique, extensive and complex. However, little is known about this experience from the patient's perspective. Design: Constructivist grounded theory, informed by Kathy Charmaz, was used to explore the personal, social and structural factors that influence patients' experiences of acute deterioration and MET encounter. Methods: Using a semi-structured interview guide, in-depth individual interviews were conducted with 27 patients from three healthcare services in Victoria, Australia. Data were collected over a 12-month period from 2018 to 2019. Interview data were analysed using grounded theory processes. Findings: Contextual factors exert a powerful influence on patients' experiences of acute deterioration and MET encounter. The most significant factors identified include patients' expectations and illness perception, relationship with healthcare professionals during MET call and past experiences of acute illness. The expectations and perceptions patients had about their disease can condition their overall experience. Healthcare professional–patient interactions can significantly impact quality of care, patient experience and recovery. Patients' experiences of illness and healthcare can impact a person's future health-seeking behaviour and health status. Conclusion: Patients' actions and processes about their experiences of acute deterioration and MET encounter are the result of the complex interface of contextual factors. Impact: The findings from this study have highlighted the need for revised protocols for screening and management of patients who experience acute deterioration. © 2022 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.
- Authors: Chung, Catherine , McKenna, Lisa , Cooper, Simon
- Date: 2022
- Type: Text , Journal article
- Relation: Journal of Advanced Nursing Vol. 78, no. 12 (2022), p. 4062-4070
- Full Text:
- Reviewed:
- Description: Aim: This paper explores the personal, social and structural factors that influence patients' experiences of acute deterioration and medical emergency team (MET) encounter. Background: Patient experience is recognized as a means of assessing healthcare delivery with a positive experience being linked to high-quality healthcare, improved patient safety and reduced length of stay. The experience of acute deterioration is unique, extensive and complex. However, little is known about this experience from the patient's perspective. Design: Constructivist grounded theory, informed by Kathy Charmaz, was used to explore the personal, social and structural factors that influence patients' experiences of acute deterioration and MET encounter. Methods: Using a semi-structured interview guide, in-depth individual interviews were conducted with 27 patients from three healthcare services in Victoria, Australia. Data were collected over a 12-month period from 2018 to 2019. Interview data were analysed using grounded theory processes. Findings: Contextual factors exert a powerful influence on patients' experiences of acute deterioration and MET encounter. The most significant factors identified include patients' expectations and illness perception, relationship with healthcare professionals during MET call and past experiences of acute illness. The expectations and perceptions patients had about their disease can condition their overall experience. Healthcare professional–patient interactions can significantly impact quality of care, patient experience and recovery. Patients' experiences of illness and healthcare can impact a person's future health-seeking behaviour and health status. Conclusion: Patients' actions and processes about their experiences of acute deterioration and MET encounter are the result of the complex interface of contextual factors. Impact: The findings from this study have highlighted the need for revised protocols for screening and management of patients who experience acute deterioration. © 2022 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.
Review article : use of the team emergency assessment measure in the rating of emergency teams' non-technical skills : a mapping review
- Cooper, Simon, Connell, Clifford, Cant, Robyn
- Authors: Cooper, Simon , Connell, Clifford , Cant, Robyn
- Date: 2023
- Type: Text , Journal article , Review
- Relation: EMA - Emergency Medicine Australasia Vol. 35, no. 3 (2023), p. 375-383
- Full Text:
- Reviewed:
- Description: The present study aims to explore the utility of the Team Emergency Assessment Measure (TEAM) in relation to the enhancement of emergency team non-technical skills based on research conducted over the last decade. In this mapping review, a citation mining process identified 22 primary studies for inclusion, published between 2012 and 2022. It provides outcome data on emergency teams' non-technical skills following team training and/or real-life patient emergencies. Emergency team studies related to resuscitation teams (adult, paediatric, newborn and obstetric cases) and medical emergency team (MET) management of patient deterioration. Team performance ratings varied, ranging from approximately 90% for experienced clinical teams down to 38% for students. Statistically significant improvements in performance were notable following training and/or repeated practice. Validity evidence, across 11 studies that provided change data described positive learning outcomes and moderate intervention effects. However, according to Kirkpatrick's model of educational evaluation the studies were limited to professional development phases of learning and immediate post-training assessments rather than care quality improvement. The review highlights a lack of studies evidencing quality improvement or clinical impact such as change of patient care practice or health service performance. There is a need to conduct well-designed studies that explore both technical and non-technical skills of resuscitation teams and METs. Currently, non-technical skills training and repeated performance evaluations using the TEAM contribute immensely to the proficiency of emergency teams. © 2023 The Authors. Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine.
- Authors: Cooper, Simon , Connell, Clifford , Cant, Robyn
- Date: 2023
- Type: Text , Journal article , Review
- Relation: EMA - Emergency Medicine Australasia Vol. 35, no. 3 (2023), p. 375-383
- Full Text:
- Reviewed:
- Description: The present study aims to explore the utility of the Team Emergency Assessment Measure (TEAM) in relation to the enhancement of emergency team non-technical skills based on research conducted over the last decade. In this mapping review, a citation mining process identified 22 primary studies for inclusion, published between 2012 and 2022. It provides outcome data on emergency teams' non-technical skills following team training and/or real-life patient emergencies. Emergency team studies related to resuscitation teams (adult, paediatric, newborn and obstetric cases) and medical emergency team (MET) management of patient deterioration. Team performance ratings varied, ranging from approximately 90% for experienced clinical teams down to 38% for students. Statistically significant improvements in performance were notable following training and/or repeated practice. Validity evidence, across 11 studies that provided change data described positive learning outcomes and moderate intervention effects. However, according to Kirkpatrick's model of educational evaluation the studies were limited to professional development phases of learning and immediate post-training assessments rather than care quality improvement. The review highlights a lack of studies evidencing quality improvement or clinical impact such as change of patient care practice or health service performance. There is a need to conduct well-designed studies that explore both technical and non-technical skills of resuscitation teams and METs. Currently, non-technical skills training and repeated performance evaluations using the TEAM contribute immensely to the proficiency of emergency teams. © 2023 The Authors. Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine.
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