HEADS-UP: a structured team intervention to improve safety and quality on medical wards
- Conditions
- Quality and safety of inpatient medical careNot Applicable
- Registration Number
- ISRCTN34806867
- Lead Sponsor
- IHR Imperial Patient Safety Translational Research Centre
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Completed
- Sex
- All
- Target Recruitment
- 7840
1. Health professionals on participating medical wards available to take part in the HEADS-UP briefings
2. All patients admitted to those wards during the study period, unless they meet one of the exclusion criteria
Patient exclusion criteria:
1. Time spent on the specified ward comprising less than 50% of the total inpatient stay
2. Discharge to a new skilled care facility or other hospital (i.e., not the patient’s address at the time of admission; discharge to a new facility typically incurs substantial delays, outside of the ward team’s control)
3. Multiple intra-hospital ward transfers. A single transfer from the initial admissions unit to a downstream medical ward is permitted. One further transfer to an escalation area to facilitate discharge (whereby the patient spends less than 24 hours in the escalation area immediately prior to their discharge home) is also permitted
4. Admission to the high dependency unit or ICU
5. Elective admission or direct admission from another hospital
6. Surgeon-directed care for more than 24 hours during the inpatient stay
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Excess length of stay (a surplus stay of 24 hours or more, compared to peer institutions' Healthcare Resource Groups-predicted length of stay), measured in each cluster each month (according to the stepped wedge design) over the course of the 14-month study period
- Secondary Outcome Measures
Name Time Method 1. Excess length of stay or readmission within 30 days, measured in each cluster each month<br>2. In-hospital death or death/readmission within 30 days, measured in each cluster each month<br>3. Complications of care (hospital-acquired infections and pressure ulcers), measured in each cluster each month<br>4. Processes of escalation of care (use of the ICU outreach service, unplanned ICU admissions, and cardiac arrest calls), measured in each cluster each month<br>5. Staff engagement with incident reporting, measured in each cluster each month<br>6. Patient safety and teamwork subsections of the Safety Attitudes Questionnaire, at baseline and then 6 months later