The Effect of an Physician-Nurse Supplementary Triage Assistance Team on Emergency Department Patient Wait Times (MDRNSTAT)

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Ivy Cheng, Sunnybrook Health Sciences Centre
ClinicalTrials.gov Identifier:
NCT00991471
First received: October 5, 2009
Last updated: October 25, 2012
Last verified: October 2012
  Purpose

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


Condition Intervention
Emergencies [Disease/Finding]
Behavioral: Interaction with MDRN STAT
Behavioral: No MDRNSTAT

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Health Services Research
Official Title: A Cluster Randomized Trial of the Effect of an Physician-Nurse Supplementary Triage Assistance Team (MDRN STAT) on Emergency Department Patient Wait Times

Resource links provided by NLM:


Further study details as provided by Sunnybrook Health Sciences Centre:

Primary Outcome Measures:
  • Effectiveness of the MDRN STAT on emergency department wait times [ Time Frame: Time from triage to time of discharge from ED ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Cost-Effectiveness of a MDRN STAT in the Emergency Department [ Time Frame: 6 months, of 50 MDRN STAT shifts, randomized with non-intervention ] [ Designated as safety issue: No ]

Enrollment: 6300
Study Start Date: September 2009
Study Completion Date: February 2010
Primary Completion Date: February 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Interaction with MDRN STAT
Interaction with MDRNSTAT at triage to obtain orders for investigations and/or treatment
Behavioral: Interaction with MDRN STAT
Interaction with MDRNSTAT at triage to obtain orders for investigations and/or treatment
Experimental: Control: No MDRNSTAT
Control group
Behavioral: No MDRNSTAT
Standard management of nurse-only triage for assignment of CTAS
Other Name: Standard triage

Detailed Description:

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 here a MDRN STAT is assigned

Exclusion Criteria:

  • None
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00991471

Locations
Canada, Ontario
Sunnybrook Health Sciences Center
Toronto, Ontario, Canada, M1N 0A1
Sponsors and Collaborators
Sunnybrook Health Sciences Centre
Investigators
Principal Investigator: Ivy Cheng, FRCP Sunnybrook Hospital Emergency Department
  More Information

No publications provided by Sunnybrook Health Sciences Centre

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Ivy Cheng, Dr. Ivy Cheng, Sunnybrook Health Sciences Centre
ClinicalTrials.gov Identifier: NCT00991471     History of Changes
Other Study ID Numbers: 226-2009
Study First Received: October 5, 2009
Last Updated: October 25, 2012
Health Authority: Canada: Ethics Review Committee

Keywords provided by Sunnybrook Health Sciences Centre:
Emergency Department Wait Times
Physician Nurse at Triage
Overcrowding
CostEffectiveness

Additional relevant MeSH terms:
Emergencies
Disease Attributes
Pathologic Processes

ClinicalTrials.gov processed this record on October 19, 2014