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Clinical Trials/NCT02524080
NCT02524080UnknownNot Applicable

Healthcare at Optimal Care Level for Patients Who Needs Primary Care - Collaboration Between Care Providers From The Emergency Medical Services' Perspective

University of Boras0 sites200 target enrollmentStarted: September 1, 2011Last updated:
Conditions
Interventions

Trial Snapshot

Phase
Not Applicable
Enrollment
200
Primary Endpoint
To measure patient trust in healthcare - Questionnaire

Study Overview

Brief Summary

If patients get to optimal level of healthcare directly it will prevent suffering for both patients and their relatives and moreover save a lot of resources. In the project "Care at the right care level" (CRC) the Emergency Medical Services (EMS) will triage patients who are in need of primary health care to the Primary Care (PC) instead of to the Emergency Department (ED). This intervention should be implemented with the same medical safety as with traditional care in the ED and the patient and their relatives should experience corresponding confidence to the healthcare provider. To prepare this intervention this patient group and their care needs have to be identified by a retrospective journal review and a guideline has to be developed. To evaluate the patients' and their relatives' experience of the intervention, finally interviews will be implemented. This project is expected to provide answers whether it is possible to triage non-urgent patients to another care level with the same medical safety and that the patients experience the same confidence in healthcare. And further it will answer the question, if the care providers around the patient manage to collaborate.

Detailed Description

Background

The research has a caring science approach, which has the patient in focus, with the general aim to describe care that strengthens and supports health. Further, a health care science approach recognizes the patient's suffering as a motivation for care.

In this study a non-urgent patient is a patient with illness, injury or ill-health suitable for the health care received in PC. The PC is able to take care of problems that not urgent and unlikely to require admission. The problem should not need specialized service in an ED, such as facilities, urgent intervention, rapid and/or complex diagnostic and could equally be managed at the PC.

For increased survival, reduced risk of complications and ability to quickly return to a functional life, it is important that there is a coherent chain of care. The EMS with the Prehospital Emergency Nurses (PEN:s) is an important part of many treatment chains, fast tracks and pathways, for example for patients with stroke, heart attack, hip fracture and geriatric care.The care model the EMS currently follows, means that virtually all patients transported to ED regardless of medical need and seriousness, which is consistent with current medical guidelines. Studies shows that around 25 % of patients arriving to the ED should have been treated at another level of care for having the right care. There is also a connection between increased mortality and overloading in the ED.

The need for emergency care is large and tends to increase, particularly in the elderly population (≥ 65 years). For resources to be utilized effectively, the health care has to be given at the level of care that is most appropriate. This requires that different providers that all have a responsibility for the patients can think outside the box, based on the individual patient's need of care. In addition, assumes cooperation and coordination to enable organizational change, which can provide good care from the patient's perspective.

Study Design

Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel
Primary Purpose
Treatment
Masking
Single (Participant)

Eligibility Criteria

Ages
18 Years to — (Adult, Older Adult)
Accepts Healthy Volunteers
No

Inclusion Criteria

  • •Un-urgent patient in ambulance
  • •Age from 18 years
  • •No communication problems
  • •No dementia or disorientation
  • •Not in need of special examinations

Exclusion Criteria

  • Not provided

Arms & Interventions

Emergency Department

Other

Triage to optimal healthcare level

Intervention: Triage to optimal healthcare level (Procedure)

Healthcare Center

Other

Triage to optimal healthcare level

Intervention: Triage to optimal healthcare level (Procedure)

Outcomes

Primary Outcomes

To measure patient trust in healthcare - Questionnaire

Time Frame: 2-3 days

A lickert scale with possible responses as follows (scores in parentheses): strongly disagree (1), disagree (2), neither disagree nor agree (3), agree (4) and strongly agree (5).

Secondary Outcomes

No secondary outcomes reported

Investigators

Sponsor Class
Other
Responsible Party
Principal Investigator
Principal Investigator

Birgitta Wireklint Sundström

Birgitta Wireklint Sundström, RNAN, PhD (Associate professor)

University of Boras

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