Potential Improvements in Emergency Department Care for Cancer Patients According to Clinical Staff

Cancer Clinical Trial

— OVERSEE-II  

Official title:

Identification of Potential Improvements in the Acute Care Pathway for Cancer Patients in the Emergency Department (OVERSEE - II Trial)

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05974800
• Other study ID #: 10842
• Status: Recruiting
• Start date: February 2, 2024
• Est. completion date: July 1, 2024

Study information

• Verified date: February 2024
• Source: Erasmus Medical Center
• Contact: Jason den Duijn
• Phone: +31107040704
• Email: j.denduijn[@]erasmusmc.nl
• Is FDA regulated: No
• Study type: Observational [Patient Registry]

Clinical Trial Summary

The goal of this Single center prospective cross-sectional study is to identify the facilitators and barriers among caregivers in the emergency department that influence disposition of patients with solid and hematology malignancies. The main question it aims to answer is to categorize the facilitators and barriers identified by three groups of emergency department (ED) staff. Participants will be asked for permission, afterwards a short interview will be held with the different ED caregivers (ED nurse, attending physician and supervising physician).

Description:

The goal of this to identify the facilitators and barriers among caregivers in the emergency department (ED) that influence disposition of patients with solid and hematology malignancies. Participants will be asked for permission, afterwards a short interview will be held with the different caregivers (ED nurse, attending physician and supervising physician) in the ED. The interviews will be held in the order of the ED care pathway, meaning ED nurse first, treating physician second and supervising physician at last. The interviews will be conducted for every patient with each of the caregivers. Each interview will be conducted after the caregiver has made the first examination of the patient. The interview focuses on several parts of the emergency care process: The first part is regarding the actions that are executed during an ED visit. We will establish which actions are executed and why. The second part is regarding the suspected outcome for the patient. The third part will be about any potential improvements to the emergency care process for the patient.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 75
• Est. completion date: July 1, 2024
• Est. primary completion date: May 1, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Patients with solid or hematological malignancies and receiving system therapy or having received systemic therapy within the last 3 months.
• Presented at or admitted from the emergency department for the oncology, hematology, neuro- or lung-oncology clinical unit.
• Awake and conscious.
• Possible to answer questions within the same shift / day after presentation in the ED.

Exclusion Criteria:

• <18 years old.
• Only received a surgical intervention as cancer treatment.
• Not willing or able to give written informed consent.

Related Conditions & MeSH terms

• Cancer
• Emergencies

Intervention

Behavioral:
• Emergency department caregivers interview
The interview focuses on several parts of the emergency care process: The first part is regarding the actions that are executed during an emergency department visit. We will establish which actions are executed and why. The second part is regarding the suspected outcome for the patient. The third part will be about any potential improvements to the emergency care process for the patient.

Locations

Country	Name	City	State
Netherlands	Erasmus MC	Rotterdam	Zuid-Holland

Sponsors (1)

Lead Sponsor	Collaborator
Erasmus Medical Center

Country where clinical trial is conducted

Netherlands, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Patient characteristics	age, sex, type of cancer, type of treatment, main complaint, triage category, number of prior ED visits.	Through study completion, an average of 6 months
Primary	Clusters of facilitator and barriers identified by the emergency department (ED) nurse	(Sub)Clusters of facilitator and barriers identified by the ED nurse for the ED care of patients with cancer	Through study completion, an average of 6 months
Primary	Clusters of facilitator and barriers identified by the treating physician	(Sub)Clusters of facilitator and barriers identified by the treating physician for the ED care of patients with cancer	Through study completion, an average of 6 months
Primary	Clusters of facilitator and barriers identified by the supervising physician	(Sub)Clusters of facilitator and barriers identified by the supervising physician for the ED care of patients with cancer	Through study completion, an average of 6 months
Secondary	Emergency department (ED) length of stay (LOS)	Emergency department length of stay	Through study completion, an average of 6 months
Secondary	Disposition	Outcome after ED admission, being home or admission	Through study completion, an average of 6 months
Secondary	Correlation between ED-LOS and disposition	Correlation between ED-LOS and disposition	Through study completion, an average of 6 months
Secondary	Years of medical experience	Number of years a medical staffmember is working in health care	Through study completion, an average of 6 months
Secondary	Need for imaging	Was imaging ordered during ED visit and which kind	Through study completion, an average of 6 months
Secondary	ED nurse agreement of disposition	Agreement between ED nurse expected disposition and the actual disposition	Through study completion, an average of 6 months
Secondary	Attending physician agreement of disposition	Agreement between treating physician expected disposition and the actual disposition	Through study completion, an average of 6 months
Secondary	Supervising physician agreement of disposition	Agreement between supervising physician expected disposition and the actual disposition	Through study completion, an average of 6 months
Secondary	Time-to-disposition	The time between patient's arrival at the ED and the decision to disposition	Through study completion, an average of 6 months
Secondary	Time-to-ward	The time between the decision to hospitalize and the arrival at the ward	Through study completion, an average of 6 months
Secondary	Correlation between time-to-disposition and the ED-LOS	Correlation between time-to-disposition and the ED-LOS	Through study completion, an average of 6 months
Secondary	Correlation between time-to-ward and the ED-LOS	Correlation between time-to-ward and the ED-LOS	Through study completion, an average of 6 months
Secondary	Difference in categories	The difference in the percentages in categories between the different caregivers	Through study completion, an average of 6 months
Secondary	ED nurse summary of actions	Summary of actions taken by ED nurse in the ED care for patients with cancer	Through study completion, an average of 6 months
Secondary	Attending physician summary of actions	Summary of actions taken by attending physician in the ED care for patients with cancer	Through study completion, an average of 6 months
Secondary	Supervising physician summary of actions	Summary of actions taken by supervising physician in the ED care for patients with cancer	Through study completion, an average of 6 months
Secondary	ED crowding	Degree of crowding in the ED, consisting of number of patients in the ED and the ED crowding color code	Through study completion, an average of 6 months
Secondary	Difference in clusters per group between day, evening and night	Difference in clusters per ED staff group between day, evening and night	Through study completion, an average of 6 months
Secondary	Difference in clusters per group between weekdays and weekend	Difference in clusters per group between weekdays (Monday 08:00 till Friday 16:00) and weekend (Friday 16:01 till Monday 7:59)	Through study completion, an average of 6 months