The ID-CARE study

  • Research type

    Research Study

  • Full title

    A formative evaluation of the implementation of interventions to identify deterioration and activate critical care outreach review following escalation

  • IRAS ID

    343605

  • Contact name

    Rebecca Lawton

  • Contact email

    r.j.lawton@leeds.ac.uk

  • Sponsor organisation

    Bradford Teaching Hospitals NHS Foundation Trust

  • Clinicaltrials.gov Identifier

    N/a, N/a

  • Duration of Study in the UK

    1 years, 3 months, 30 days

  • Research summary

    In March 2024, the rollout of Martha’s rule in 100 NHS Trusts where 24/7 critical care outreach was in place, was announced, with implementation from June 2024. Martha’s rule provides patients and their families, as well as staff, with a widely advertised and easily accessible route to call for a rapid review from an independent clinical review team where they are concerned that a patient is deteriorating and they don’t feel that their concerns are being taken seriously by the local team. Martha’s Rule also involves implementing a structured approach to obtaining information relating to a patient’s condition directly from patients and their families at least daily. In the first instance, this will cover all inpatients in acute and hospital trusts.

    Our formative evaluation will address a number of research questions about the potential and actual impact of the first phase of implementation/rollout of Martha’s Rule for services, healthcare staff and patients/families as well as factors that contribute to successful implementation. The primary focus of the evaluation will involve a brief case study across three of the final 143 selected pilot sites, primarily conducting short intensive and structured observations in selected wards and critical care outreach (CCO) teams, and conducting a small number of interviews with frontline, operational and strategic staff and patients/family members on base wards at each site. This will be accompanied by a systematic review of literature and a survey of the general population about their awareness of Martha’s Rule conducted in collaboration with PickerEurope – a separate university ethics application will be made to carry out the survey work.

    With input from stakeholder groups, we will collate and triangulate this evidence to produce a set of recommendations including for future summative research, changes to policy, and guidance for other trusts that are planning to implement Martha’s rule.

  • REC name

    Yorkshire & The Humber - Leeds West Research Ethics Committee

  • REC reference

    24/YH/0184

  • Date of REC Opinion

    16 Aug 2024

  • REC opinion

    Favourable Opinion