Who should lead hospital rapid response teams?
Rapid Response Teams - How and Who? A Randomized Controlled Trial Examining the Composition of the RRT in a General Hospital
This trial will test whether a Critical Care Outreach Team led by an ICU nurse plus ward clinicians works as well as a Medical Emergency Team led by an ICU doctor for adult patients on general wards who need rapid response care.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 1500 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Nordsjaellands Hospital Academic / other |
| Locations | 1 site (Hillerød, Danmark) |
| Trial ID | NCT04507737 on ClinicalTrials.gov |
What this trial studies
This is a one-sided blinded, locally randomized trial comparing two rapid response team compositions: a Critical Care Outreach Team (ICU nurse plus a general ward physician and nurse) versus a Medical Emergency Team (ICU doctor plus ICU nurse and ward clinician). Adult patients on general wards who trigger an RRT call are randomized 1:1 at the time of the call using a centrally generated sequence implemented with sealed opaque envelopes. Primary outcomes will be analyzed in the intention-to-treat population, with secondary outcomes analyzed per-protocol excluding protocol violations. Investigators are blinded to allocation, although responding clinicians cannot be blinded to which team attends.
Who should consider this trial
Good fit: Adults (age 18 and over) admitted to general hospital wards who require a rapid response team call are eligible candidates.
Not a fit: Patients in delivery, anesthetic department areas (ICU, HDU, post-op, operating theatre, same-day surgery), those not admitted at the time of the call (ED evaluation, outpatients, imaging), or those who cannot be randomized at the time of call are not expected to benefit from this trial.
Why it matters
Potential benefit: If successful, a nurse-led CCOT could provide care comparable to doctor-led METs while freeing intensive care physicians for other critical duties and improving resource use.
How similar studies have performed: Previous studies of varied rapid response team compositions, including nurse-led outreach models, have shown mixed but sometimes promising results, so the approach has partial precedent but is not definitively settled.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Admitted to any general ward of the hospital AND * Aged ≥ 18 years AND * In need of RRT attention Exclusion Criteria: * Age \< 18 * Admitted to the delivery ward * Admitted to any ward in the anesthetic department * ICU * High Dependency Unit * Post Operation Department * Operating Theatre * Same Day Admissions - Surgery Ward * Not admitted at the time of call * Evaluation track in Emergency department (prior to being seen by a doctor) * Out-Patient departments * X-ray department * Any patient who cannot be randomized at the time of call
Where this trial is running
Hillerød, Danmark
- Nordsjællands Hospital — Hillerød, Danmark, Denmark (Recruiting)
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.