Role of Provider-at-Triage on ED Efficiency and Quality of Care

NCT ID: NCT02703701

Last Updated: 2019-09-23

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 439 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2015-10-31
• Study Completion Date: 2016-03-31

Brief Summary

The United States spends over $8,000 per capita annually on health care and its health care system is more expensive than other developed countries. Even with high per capita costs and a high proportion of physician specialists, the US lags in health care performance from patients' perspectives.

The hospital emergency department (ED) is often the portal of entry for patients seeking health care services and is therefore an ideal setting for initiatives to improve efficiency of care delivery and patient satisfaction. Reduction in wait times, enhanced information delivery and ED staff service quality all have a positive influence on patient perception of health care quality and satisfaction.

Prior studies have attempted to increase patient satisfaction by improving staff communication and courtesy, implementing a patient satisfaction team in triage, and delivering information to patients in a timely manner. Another strategy to increase the efficiency of ED operations is adding a physician to triage to perform brief medical screenings and initiate necessary patient testing and treatment. This contrasts to usual practice in which physicians evaluate patients only following registration and nurse assessment of illness or injury severity.

Detailed Description

This study will assess the impact of early patient assessment by a physician at Emergency Department (ED) triage on patient perception of information delivery, overall patient satisfaction and ED efficiency. ED efficiency will be assessed by ED length of patient stay, ED left-without-being-seen and ED left during treatment rates.

Participants who decide to take part in this study, will be asked questions by research staff, who will document responses on a secure iPAD device. The survey will ask participants how they feel about their health condition, the emergency department wait, the care they received in the emergency department and how satisfied the participant was with the care received.

Conditions

Patient Satisfaction With Emergency Department Efficiency

Study Design

• Observational Model Type: CASE_CONTROL
• Study Time Perspective: PROSPECTIVE

Study Groups

Usual Care

Group enrolled during normal emergency department operating procedures (without a physician present at triage).

Usual Care

Intervention Type: OTHER

No physician at triage

Physician at Triage

Group enrolled while a physician is present at triage.

Physician at triage

Intervention Type: BEHAVIORAL

A physician embedded at triage

Interventions

Physician at triage

A physician embedded at triage

Intervention Type: BEHAVIORAL

Usual Care

No physician at triage

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

Participants are eligible to participate in the study if they are:

• English speaking
• Without hemodynamic or respiratory compromise
• Do not have a nurse-assigned triage severity score of Emergency Severity Index 1 (most severe illness or injury score).

Exclusion Criteria

Participants will be excluded if they are:

• Unwilling or unable to sign an informed consent
• In police custody
• Too ill to participate in study.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 110 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

University of Florida

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Brandon Allen, MD

Role: PRINCIPAL_INVESTIGATOR

Univeristy of Florida

Locations

UF Health

Gainesville, Florida, United States

Countries

United States

Other Identifiers

IRB201500586

Identifier Type: -

Identifier Source: org_study_id