RESPOND Study - WP1 & WP2
Research type
Research Study
Full title
RESPOND study (Rescue for Emergency Surgery Patients Observed to uNdergo acute Deterioration) - Work Packages 1 & 2 (WP1 & WP2)
IRAS ID
270881
Contact name
Peter McCulloch
Contact email
Sponsor organisation
University of Oxford / Clinical Trials and Research Governance
Clinicaltrials.gov Identifier
000000000, 000000000
Duration of Study in the UK
5 years, 2 months, 28 days
Research summary
This study (WP1 & WP 2) is part of wider, complex study studying a healthcare situation where system problems are costing lives. In Emergency General Surgery (EGS), dealing mainly with patients with severe abdominal pain, the death rate after abdominal surgery to find out what’s wrong (called ‘laparotomy’) is 5 times higher than for similar routine surgery. Studies of serious complications after major operations show that when patients deteriorate after surgery, their chances of survival depend on how quickly and how well clinical teams react. Up to 3000 deaths per year could be avoided if these systems were improved. Death rates after routine major surgery are lower in busier hospitals than in smaller ones. We know this is not because larger units have less complications after surgery, but because they respond to them more effectively. Investigations following complications and deaths in EGS frequently report that the teams involved did not respond rapidly and correctly to deterioration. This is probably an important factor in the high EGS laparotomy death rate. An effective response needs both early detection of problems and an efficient rescue system. We have tried monitoring patients’ blood pressure, temperature, heart and breathing rates more reliably, but this has not reduced death rates consistently, suggesting that improving rescue systems is more important. Research on why rescue systems sometimes don’t work highlights communication and co-operation problems, and difficulties in getting specialist help quickly. Involving patients and families may improve this process.
WP1&2 will use Human Factors science to analyse how EGS teams currently treat deteriorating patients, and help them develop better response systems. Testing these developments will form the focus of subsequent parts of the overall study (WP3&4) and separate ethics approval will be sought for these at a later stage.REC name
East of England - Cambridge East Research Ethics Committee
REC reference
20/EE/0259
Date of REC Opinion
23 Nov 2020
REC opinion
Further Information Favourable Opinion