Triaging and Referring in Adjacent General and Emergency Departments (TRIAGE)

Universiteit Antwerpen

Status: Completed

Conditions: Triage

Treatments: Other: Usual care; Other: Triage with referral to primary care

Study type: Interventional

Funder types: Other

Identifiers

NCT03793972

T000718N

Details and patient eligibility

About

Introduction: Patients who might also go to the general practitioner (GP) frequently consult emergency departments (ED). This leads to additional costs for both government and patient and a high workload for emergency physicians in Flanders. The Belgian government wants to address this problem by improved collaboration between EDs and general practice cooperatives (GPCs).

Intervention: Patients presenting at the ED during out-of-hours (OOH) will be triaged and allocated to the most appropriate service. For this purpose the Manchester Triage System (MTS) which is commonly used in Flemish hospitals, will be extended (eMTS). By doing so a trained nurse will be able to diverge suitable patients towards the GPC.

Methodology: The investigators will conduct a cluster randomised controlled trial in which eligible ED patients will be diverged to the GPC using the eMTS. The investigators will collect data using the iCAREdata database. The investigators will study the use of the eMTS, the effectiveness and effects of triage, work load changes, epidemiology at both departments, patient safety, health insurance (HIS) and patient expenditures. Furthermore, facilitators and barriers will be studied and an incident analysis of problem cases will be performed.

Outcome: The primary outcome is the proportion of patients who enter the ED and are handled by the GP after triage. Secondary outcome measurements are related to safety: referral rate to the ED by the GP, proportion of patients not following the triage advice and file review for selected patients.

Enrollment: 8,158 patients

Sex: All

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• availability of a Belgian citizen national insurance number

Exclusion criteria

• Patients arriving at the ED by an ambulance with a doctor or nurse
• Patients all ready admitted to an other hospital department

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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8,158 participants in 2 patient groups

Triage with referral to primary care

Experimental group

Description:

Triage and referral according to eMTS.

Treatment:

Other: Triage with referral to primary care

Triage without referral to primary care

Active Comparator group

Description:

Weekends with usual care

Treatment:

Other: Usual care