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

Not Applicable

Completed

• Conditions: Emergencies
• Interventions: Behavioral: No MDRNSTAT; Behavioral: Interaction with MDRN STAT

• Registration Number: NCT00991471
• Lead Sponsor: Sunnybrook Health Sciences Centre

Brief 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

Detailed 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.

Study Timeline

• Study Start: 2009-09
• Study First Submitted: 2009-10-05
• Study First Submitted QC: 2009-10-07
• Study First Posted: 2009-10-08
• Primary Completion: 2010-02
• Study Completion: 2010-02
• Status Verified: 2017-10
• Last Update Submitted: 2017-10-27
• Last Update Posted: 2017-10-31

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 6300

Inclusion Criteria

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

Exclusion Criteria

• None

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Control: No MDRNSTAT	No MDRNSTAT	Control group
Interaction with MDRN STAT	Interaction with MDRN STAT	Interaction with MDRNSTAT at triage to obtain orders for investigations and/or treatment

Primary Outcome Measures

Name	Time	Method
Effectiveness of the MDRN STAT on emergency department wait times	Time from triage to time of discharge from ED

Secondary Outcome Measures

Name	Time	Method
Cost-Effectiveness of a MDRN STAT in the Emergency Department	6 months, of 50 MDRN STAT shifts, randomized with non-intervention

Trial Locations

Locations (1)

Sunnybrook Health Sciences Center; 🇨🇦 Toronto, Ontario, Canada