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

Emergencies Clinical Trial

— MDRNSTAT  

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

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00991471
• Other study ID #: 226-2009
• Status: Completed
• Phase: N/A
• First received: October 5, 2009
• Last updated: October 27, 2017
• Start date: September 2009
• Est. completion date: February 2010

Study information

• Verified date: October 2017
• Source: Sunnybrook Health Sciences Centre
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

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

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 6300
• Est. completion date: February 2010
• Est. primary completion date: February 2010
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: N/A and older

Eligibility

Inclusion Criteria:

• Patients arriving from 8:00-14:30 during a day here a MDRN STAT is assigned

Exclusion Criteria:

Related Conditions & MeSH terms

• Emergencies

Intervention

Behavioral:
• Interaction with MDRN STAT
Interaction with MDRNSTAT at triage to obtain orders for investigations and/or treatment
• No MDRNSTAT
Standard management of nurse-only triage for assignment of CTAS

Locations

Country	Name	City	State
Canada	Sunnybrook Health Sciences Center	Toronto	Ontario

Sponsors (1)

Lead Sponsor	Collaborator
Sunnybrook Health Sciences Centre

Country where clinical trial is conducted

Canada, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Effectiveness of the MDRN STAT on emergency department wait times		Time from triage to time of discharge from ED
Secondary	Cost-Effectiveness of a MDRN STAT in the Emergency Department		6 months, of 50 MDRN STAT shifts, randomized with non-intervention