Prevention, Detection and Rescue of Deteriorating Patients. Which combinations of interventions are most effective?

A research collaboration between National Cardiac Arrest Audit (NCAA) and the London School of Hygiene and Tropical Medicine

Status: In dissemination

The purpose of the project

This study will identify which hospital services designed to identify and respond quickly to acutely ill patients on the wards (observation charts, critical care nurse outreach teams, education programmes etc.), and in which combinations, have the strongest influence on the number and outcome of ward-based cardiac arrests.

How the study will be conducted

The study will involve:

  • in-depth work in 20 acute Trusts to gain a better understanding of how interventions are working in practice, taking into account issues such as how many wards use them, leadership of teams and training support
  • the development of a questionnaire for all hospitals in the National Cardiac Arrest Audit (NCAA) to identify how services vary, which is likely to be a key reason for the differences in cardiac arrest rates and outcomes
  • linking findings from the survey to NCAA, Hospital Episode Statistics inpatient data and Office for National Statistics mortality data to determine which packages of interventions are associated with the lowest cardiac arrests and the best outcomes

Data linkage will be undertaken by the NHS Digital Data Access Request Service (DARS) acting as a trusted third party. The NCAA data including patient identifiers (NHS number, date of birth, sex and postcode) will be securely transfer to DARS who will perform the data linkage and will return a common key that can be used to link all records of the same patient across the datasets. Anonymised data will then be securely transferred from ICNARC to LSHTM to be used in the analysis.

If you have been treated in a hospital participating in NCAA and do not wish data collected during your stay in hospital to be included in the study, please contact the health care team at the hospital where you were treated who will inform ICNARC.

When is it taking place?

The project was commissioned in May 2014 and completed in September 2017.

Who is leading the project?

Dr Helen Hogan, Associate Professor, London School of Hygiene and Tropical Medicine

Further information

This project is funded by the National Institute for Health Research (NIHR) – Health Services and Delivery Research (HS&DR) Programme (Project: 12/178/18).

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