Emergencies Clinical Trial
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
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
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.
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