Emergency Department Overcrowding Clinical Trial
— EDOVSOfficial title:
A Validation Study of Emergency Department Crowding Estimation
| Verified date | June 2017 |
| Source | Baylor Research Institute |
| Contact | n/a |
| Is FDA regulated | No |
| Health authority | |
| Study type | Observational |
The aim of this study is to externally validate a new emergency department overcrowding estimation tool (SONET) developed at John Peter Smith Health Network (JPS).
| Status | Active, not recruiting |
| Enrollment | 55000 |
| Est. completion date | July 2017 |
| Est. primary completion date | January 31, 2017 |
| Accepts healthy volunteers | No |
| Gender | All |
| Age group | 18 Years to 100 Years |
| Eligibility |
Inclusion Criteria: - all adult patients visiting the emergency department or urgent care clinic at any one of the six participating sites during the allocated one month time period Exclusion Criteria: - those who do not meet inclusion criteria |
| Country | Name | City | State |
|---|---|---|---|
| n/a | |||
| Lead Sponsor | Collaborator |
|---|---|
| Baylor Research Institute | Baylor University Medical Center at Carrolton, Baylor University Medical Center at Dallas, Baylor University Medical Center at Garland, Baylor University Medical Center at McKinney, Baylor University Medical Center at Waxahachie, JPS Health Network |
Bernstein SL, Verghese V, Leung W, Lunney AT, Perez I. Development and validation of a new index to measure emergency department crowding. Acad Emerg Med. 2003 Sep;10(9):938-42. — View Citation
Epstein SK, Tian L. Development of an emergency department work score to predict ambulance diversion. Acad Emerg Med. 2006 Apr;13(4):421-6. — View Citation
Jones SS, Allen TL, Flottemesch TJ, Welch SJ. An independent evaluation of four quantitative emergency department crowding scales. Acad Emerg Med. 2006 Nov;13(11):1204-11. Epub 2006 Aug 10. — View Citation
McCarthy ML, Aronsky D, Jones ID, Miner JR, Band RA, Baren JM, Desmond JS, Baumlin KM, Ding R, Shesser R. The emergency department occupancy rate: a simple measure of emergency department crowding? Ann Emerg Med. 2008 Jan;51(1):15-24, 24.e1-2. Epub 2007 Nov 5. — View Citation
Wang H, Robinson RD, Garrett JS, Bunch K, Huggins CA, Watson K, Daniels J, Banks B, D'Etienne JP, Zenarosa NR. Use of the SONET Score to Evaluate High Volume Emergency Department Overcrowding: A Prospective Derivation and Validation Study. Emerg Med Int. 2015;2015:401757. doi: 10.1155/2015/401757. Epub 2015 Jun 8. — View Citation
Weiss SJ, Derlet R, Arndahl J, Ernst AA, Richards J, Fernández-Frackelton M, Schwab R, Stair TO, Vicellio P, Levy D, Brautigan M, Johnson A, Nick TG. Estimating the degree of emergency department overcrowding in academic medical centers: results of the National ED Overcrowding Study (NEDOCS). Acad Emerg Med. 2004 Jan;11(1):38-50. Erratum in: Acad Emerg Med. 2004 Apr;11(4):408. Fernández-Frankelton M [corrected to Fernández-Frackelton M]. — View Citation
| Type | Measure | Description | Time frame | Safety issue |
|---|---|---|---|---|
| Primary | left without being seen disposition chart review | LWBS refers to patients who have been called at least three times, using 20 minute intervals, to occupy an ED exam bed, however, do not respond. If after the third attempt the patient responds, the investigators will consider this a new patient registration/encounter. These data will be collected for each patient during the study period during initial ED registration and upon ED disposition. | 30 days | |
| Primary | emergency department 72 hour return chart review | ED 72h return will be defined to patients who re-register to the same ED as a new patient (unplanned) within 72h of a previous departure, regardless of the complaint. Planned ED revisits within 72h will be excluded. These data will be collected during initial ED registration during study period and will follow up each patient at least 72h post-discharge. | 30 days | |
| Primary | emergency department mortality | 30 days | ||
| Primary | hospital mortality | 30 days | ||
| Primary | emergency department length of stay | 30 days | ||
| Secondary | patient satisfaction survey | Patient satisfaction will be measured using Qualitick (Clearwater, FL), a real-time patient satisfaction program reporting tool using a Likert scale format. Patient will complete their Qualitick survey upon departure from ED regardless of their ED dispositions (e.g. transfer to inpatient service, discharge to home, transfer to another facility, etc.). Patients, or patient designees, will use a tablet to answer a series of questions. Patients, or their designees, have the option of omitting their name to ensure their information is kept anonymous. | 30 days | |
| Secondary | physician empathy scale | Jefferson Physician Empathy Scale, available online, will be conducted by ED staff and compared with 1) staff working different shifts with different levels of crowding; 2) the norms; 3) staff working a more balanced schedule (roughly equal numbers of day, evening, and night shifts); and 4) attending physicians versus nursing staff versus residents. Average scores will be used to determine any differences among groups. The measurement tool will be repeated 6-9 months later to determine whether dynamic changes have occurred and whether an association exists with respect to changes in operation efficiency as a function of relative ED crowding at the individual physician level during the study period. The investigators recognize that the inclusion of the psychometric tests will be, to some extent, exploratory and the most important assessment will be the simple descriptive display of the mean scores (and standard deviations). | 30 days |