Potential Improvements in Emergency Department Care for Cancer Patients According to Clinical Staff
- Conditions
- EmergenciesCancer
- Interventions
- Behavioral: Emergency department caregivers interview
- Registration Number
- NCT05974800
- Lead Sponsor
- Erasmus Medical Center
- Brief Summary
The goal of this Single center prospective cross-sectional study is to identify the facilitators and barriers among caregivers in the emergency department that influence disposition of patients with solid and hematology malignancies. The main question it aims to answer is to categorize the facilitators and barriers identified by three groups of emergency department (ED) staff. Participants will be asked for permission, afterwards a short interview will be held with the different ED caregivers (ED nurse, attending physician and supervising physician).
- Detailed Description
The goal of this to identify the facilitators and barriers among caregivers in the emergency department (ED) that influence disposition of patients with solid and hematology malignancies. Participants will be asked for permission, afterwards a short interview will be held with the different caregivers (ED nurse, attending physician and supervising physician) in the ED. The interviews will be held in the order of the ED care pathway, meaning ED nurse first, treating physician second and supervising physician at last. The interviews will be conducted for every patient with each of the caregivers. Each interview will be conducted after the caregiver has made the first examination of the patient. The interview focuses on several parts of the emergency care process: The first part is regarding the actions that are executed during an ED visit. We will establish which actions are executed and why. The second part is regarding the suspected outcome for the patient. The third part will be about any potential improvements to the emergency care process for the patient.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 59
- Patients with solid or hematological malignancies and receiving system therapy or having received systemic therapy within the last 3 months.
- Presented at or admitted from the emergency department for the oncology, hematology, neuro- or lung-oncology clinical unit.
- Awake and conscious.
- Possible to answer questions within the same shift / day after presentation in the ED.
- <18 years old.
- Only received a surgical intervention as cancer treatment.
- Not willing or able to give written informed consent.
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Cancer patients Emergency department caregivers interview All adult patients with solid or hematological malignancies and receiving systemic therapy or having received systemic therapy within the last 3 months that are admitted to the emergency department of the Erasmus medical center for the oncology, hematological, lung- and neuro-oncology medical unit are eligible for inclusion.
- Primary Outcome Measures
Name Time Method Clusters of facilitator and barriers identified by the emergency department (ED) nurse Through study completion, an average of 6 months (Sub)Clusters of facilitator and barriers identified by the ED nurse for the ED care of patients with cancer
Clusters of facilitator and barriers identified by the treating physician Through study completion, an average of 6 months (Sub)Clusters of facilitator and barriers identified by the treating physician for the ED care of patients with cancer
Clusters of facilitator and barriers identified by the supervising physician Through study completion, an average of 6 months (Sub)Clusters of facilitator and barriers identified by the supervising physician for the ED care of patients with cancer
- Secondary Outcome Measures
Name Time Method Years of medical experience Through study completion, an average of 6 months Number of years a medical staffmember is working in health care
Time-to-disposition Through study completion, an average of 6 months The time between patient's arrival at the ED and the decision to disposition
Supervising physician agreement of disposition Through study completion, an average of 6 months Agreement between supervising physician expected disposition and the actual disposition
Emergency department (ED) length of stay (LOS) Through study completion, an average of 6 months Emergency department length of stay
Disposition Through study completion, an average of 6 months Outcome after ED admission, being home or admission
ED nurse agreement of disposition Through study completion, an average of 6 months Agreement between ED nurse expected disposition and the actual disposition
Attending physician agreement of disposition Through study completion, an average of 6 months Agreement between treating physician expected disposition and the actual disposition
ED nurse summary of actions Through study completion, an average of 6 months Summary of actions taken by ED nurse in the ED care for patients with cancer
Difference in clusters per group between day, evening and night Through study completion, an average of 6 months Difference in clusters per ED staff group between day, evening and night
Correlation between time-to-ward and the ED-LOS Through study completion, an average of 6 months Correlation between time-to-ward and the ED-LOS
Correlation between ED-LOS and disposition Through study completion, an average of 6 months Correlation between ED-LOS and disposition
Need for imaging Through study completion, an average of 6 months Was imaging ordered during ED visit and which kind
Supervising physician summary of actions Through study completion, an average of 6 months Summary of actions taken by supervising physician in the ED care for patients with cancer
Difference in categories Through study completion, an average of 6 months The difference in the percentages in categories between the different caregivers
ED crowding Through study completion, an average of 6 months Degree of crowding in the ED, consisting of number of patients in the ED and the ED crowding color code
Time-to-ward Through study completion, an average of 6 months The time between the decision to hospitalize and the arrival at the ward
Correlation between time-to-disposition and the ED-LOS Through study completion, an average of 6 months Correlation between time-to-disposition and the ED-LOS
Attending physician summary of actions Through study completion, an average of 6 months Summary of actions taken by attending physician in the ED care for patients with cancer
Difference in clusters per group between weekdays and weekend Through study completion, an average of 6 months Difference in clusters per group between weekdays (Monday 08:00 till Friday 16:00) and weekend (Friday 16:01 till Monday 7:59)
Trial Locations
- Locations (1)
Erasmus MC
🇳🇱Rotterdam, Zuid-Holland, Netherlands