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

Sunnybrook Health Sciences Centre

Status: Completed

Conditions: Emergencies

Treatments: Behavioral: No MDRNSTAT; Behavioral: Interaction with MDRN STAT

Study type: Interventional

Funder types: Other

Identifiers

NCT00991471

226-2009

Details and patient eligibility

About

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

Full 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.

Enrollment: 6,300 patients

Sex: All

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

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

Exclusion criteria

• None

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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6,300 participants in 2 patient groups

Interaction with MDRN STAT

Experimental group

Description:

Interaction with MDRNSTAT at triage to obtain orders for investigations and/or treatment

Treatment:

Behavioral: Interaction with MDRN STAT

Control: No MDRNSTAT

Experimental group

Description:

Control group

Treatment:

Behavioral: No MDRNSTAT