ED Adaptive Staffing Study

Recruiting

• Conditions: Well-Being, Psychological; Emergency Medicine
• Interventions: Other: Staffing model

• Registration Number: NCT05937763
• Lead Sponsor: Oak Valley Health

Brief Summary

Emergency Departments (EDs) across Ontario are being inundated with unprecedented high patient volumes and a staffing shortage that directly impacts patient care and flow. An area of concern among EDs is the offload zone where patients are brought in by ambulance. EMS offload time is the time it takes paramedics to transfer a patient to the appropriate area within an emergency department and give hospital staff a summary of what concerns the patient is seeking care for. There are multiple factors that may delay this time, including limited staff in the offload area to complete the transfer process due to competing patient care responsibilities. The adaptive staffing model study will look to add a primary care paramedic (PCP) or a registered nurse (RN) in the offload zone during times of high ambulance volume (August to January) to help with patient care within the offload zone. This single-centered community hospital study will evaluate the benefits of having a PCP or RN, compared to the current model, on ambulance offload times, patient safety outcomes, patient treatment times, and staff well-being using three different models of staffing.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2023-06-23
• Study First Submitted QC: 2023-06-30
• Study First Posted: 2023-07-10
• Study Start: 2023-10-02
• Status Verified: 2024-03
• Primary Completion: 2024-03
• Last Update Submitted: 2024-03-20
• Last Update Posted: 2024-03-22
• Study Completion: 2024-09

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 5917

Inclusion Criteria

• Patients brought in by ambulance to hospitals emergency department offload area

Exclusion Criteria

• Patients not arriving to the hospitals emergency department offload area

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Primary Care Paramedic (PCP) Block	Staffing model	A PCP will be staffed in the emergency department offload zone 3 days a week (Monday, Wednesday, and Friday) on a 10am - 10pm shift, in addition to the standard staffing model.
Registered Nurse (RN) Block	Staffing model	An experienced emergency department RN with triage training will be staffed in the emergency department offload zone 3 days a week (Monday, Wednesday, and Friday) in a 10am - 10pm shift, in addition to the standard staffing model

Primary Outcome Measures

Name	Time	Method
Return to Service	6 months	The aim of this objective is to determine if an adaptive staffing model during peak volumes reduces ambulance offload times and return to service.
Triage Time	6 months	The aim of this objective is to compare time to triage and time to transfer of care for three models of staffing.

Secondary Outcome Measures

Name	Time	Method
Time to provider assessment	6 months
Time to disposition	6 months
Number of incident reports	6 months	Patient safety events
Case costing	6 months
Provider Feedback Survey	6 months	Explore provider perceptions (ED staff and paramedics) of each model with the aim of determining which model provides better patient care during peak volumes. Participants will self-report their perceived barriers, challenges and benefits of the staffing interventions.
Time to treatment	6 months
Well-being Index (questionnaire)	6 months	Explore staff and paramedic well-being on intervention model

Trial Locations

Locations (1)

Markham Stouffville Hospital; 🇨🇦 Markham, Ontario, Canada