Get the latest public health information from CDC: https://www.coronavirus.gov
Get the latest research information from NIH: https://www.nih.gov/coronavirus
Information about ongoing health services research and public health projects
| A cluster randomized trial of the effect of a physician-nurse supplementary triage assistance team (MDRN STAT) on emergency department patient wait times
(Archived Project) |
|
|---|---|
| Investigator (PI): | Cheng, Ivy |
| Performing Organization (PO): |
(Current): Sunnybrook Health Sciences Centre / (416) 480-6100 |
| Supporting Agency (SA): | Ministry of Health and Long-Term Care (MOHLTC), Ontario |
| Initial Year: | 2009 |
| Final Year: | 2010 |
| Record Source/Award ID: | HSR/226-2009 |
| Award Type: | Grant |
| Number of Subjects: | 1000 |
| Abstract: | The primary objective of this study is to investigate whether the introduction of a physician-nurse supplementary triage assessment team (MDRN STAT) is effective in improving time-based performance indicators for wait times. Secondary objectives will examine the quality of patient care and health care worker satisfaction and the cost-effectiveness of the program. The primary outcome measure is effectiveness of the MDRN STAT on emergency department (ED) wait times. Time frame: Time from triage to time of discharge from ED. This primary outcome measure is designated as a safety issue. The secondary outcome measure is cost-effectiveness of a MDRN STAT in the emergency department. Time frame: 6 months, of 50 MDRN STAT shifts, randomized with non-intervention. This secondary outcome measure is not designated as a safety issue. Arm: Interaction with MDRN STAT: Experimental. Patients will arrive at the triage desk and interact with the MDRN STAT (physician-nurse supplementary triage assessment team). At this time, the patient may obtain orders for investigations (bloodwork/diagnostic imaging) or therapy (analgesic, antibiotics, consultations). Assigned intervention: Behavioral: Interaction with the MDRN STAT. Meeting with a physician-nurse team at triage to obtain orders for investigations and/or treatment. In 2007, the Ontario Ministry of Health and Long-term Care (MOHLTC) declared emergency department wait times a government priority. The crisis of overcrowding and access block has become an international epidemic, affecting developing countries in Europe, North America, and Australasia. The MOHLTC has targeted 23 Ontario hospitals' prolonged wait times. Sunnybrook Health Sciences Center has been selected. Therefore, this is a quality improvement study of patient wait times and care. During a 20-week period, the MDRN STAT will be present on randomly chosen weekdays (8:00-16:00) for 50 shifts. Wait times, such as time from triage time to physician assessment, stretcher occupation, treatment orders (drugs), investigation orders (laboratory, diagnostic imaging), investigation acquisition (diagnostic imaging), consultation, bed request, discharge from ED (i.e. length of stay [LOS]) time will be analyzed. In addition, the left-without-being-seen rate (LWBS) and rate of return will be analyzed. These results will be compared to the Ontario wait-time strategy P4R targets, as well as the Canadian Triage Acuity Scale (CTAS guidelines). Economic analysis of this intervention will be done. The hospital will independently perform patient satisfaction surveys. Health care worker satisfaction survey data will be analyzed. Eligibility. Genders eligible for study: both. Accepts healthy volunteers: yes. Criteria. Inclusion criteria: Patients arriving from 8:00-14:30 during a day when a MDRN STAT is assigned. Exclusion criteria: None. |
| MeSH Terms: |
|
| Keywords: |
|
| Country: | Canada |
| State: | Ontario |
| Zip Code: | M4N 3M5 |
| UI: | 20103097 |
| CTgovId: | NCT00991471 |
| Project Status: | Archived |