Role of Provider-at-Triage on ED Efficiency and Quality of Care

Patient Satisfaction With Emergency Department Efficiency Clinical Trial

— MD at Triage  

Official title:

Effects of Provider-at-Triage on Emergency Department Efficiency, Information Delivery and Patient Satisfaction

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02703701
• Other study ID #: IRB201500586
• Status: Completed
• Start date: October 2015
• Est. completion date: March 2016

Study information

• Verified date: September 2019
• Source: University of Florida
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

The United States spends over $8,000 per capita annually on health care and its health care system is more expensive than other developed countries. Even with high per capita costs and a high proportion of physician specialists, the US lags in health care performance from patients' perspectives.

The hospital emergency department (ED) is often the portal of entry for patients seeking health care services and is therefore an ideal setting for initiatives to improve efficiency of care delivery and patient satisfaction. Reduction in wait times, enhanced information delivery and ED staff service quality all have a positive influence on patient perception of health care quality and satisfaction.

Prior studies have attempted to increase patient satisfaction by improving staff communication and courtesy, implementing a patient satisfaction team in triage, and delivering information to patients in a timely manner. Another strategy to increase the efficiency of ED operations is adding a physician to triage to perform brief medical screenings and initiate necessary patient testing and treatment. This contrasts to usual practice in which physicians evaluate patients only following registration and nurse assessment of illness or injury severity.

Description:

This study will assess the impact of early patient assessment by a physician at Emergency Department (ED) triage on patient perception of information delivery, overall patient satisfaction and ED efficiency. ED efficiency will be assessed by ED length of patient stay, ED left-without-being-seen and ED left during treatment rates.

Participants who decide to take part in this study, will be asked questions by research staff, who will document responses on a secure iPAD device. The survey will ask participants how they feel about their health condition, the emergency department wait, the care they received in the emergency department and how satisfied the participant was with the care received.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 439
• Est. completion date: March 2016
• Est. primary completion date: March 2016
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 110 Years

Eligibility

Inclusion Criteria:

Participants are eligible to participate in the study if they are:

• English speaking

• Without hemodynamic or respiratory compromise

• Do not have a nurse-assigned triage severity score of Emergency Severity Index 1 (most severe illness or injury score).

Exclusion Criteria:

Participants will be excluded if they are:

• Unwilling or unable to sign an informed consent

• In police custody

• Too ill to participate in study.

Related Conditions & MeSH terms

• Emergencies
• Patient Satisfaction With Emergency Department Efficiency

Intervention

Behavioral:
• Physician at triage
A physician embedded at triage

Other:
• Usual Care
No physician at triage

Locations

Country	Name	City	State
United States	UF Health	Gainesville	Florida

Sponsors (1)

Lead Sponsor	Collaborator
University of Florida

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Patient Satisfaction	Patient Satisfaction Score- brief survey measured on a Likert Scale; 1= Never; 2= Sometimes; 3= Usually; 4= Always; 5= Not applicable - I did not see a doctor today	60 minutes after Emergency Department triage
Secondary	Emergency Department efficiency	Impact of physician at triage on ED length of stay rates	24 hours after ED triage in minutes
Secondary	Left without being seen rate	Impact of physician at triage on left without being seen rate	12 hours after ED triage in minutes