SurgeCon: An Emergency Department Surge Management Platform
NCT ID: NCT04789902
Last Updated: 2025-10-01
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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ACTIVE_NOT_RECRUITING
NA
436052 participants
INTERVENTIONAL
2021-01-01
2026-03-31
Brief Summary
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Detailed Description
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The platform includes an eHealth component, a training program for ED staff, and a series of quality improvement initiatives. SurgeCon optimizes patient flow and creates a more patient-centric environment; it monitors ED capacity in real-time and helps address overcrowding by prescribing a series of actions customized to maximize patient flow in response to the level of demand in the ED. SurgeCon was recently piloted in a rural hospital and was associated with dramatic improvements in ED efficiency. Our time series analysis showed a significant decrease in the number of patients who left the ED without being seen by a physician (LWBS) (12.1% to 4.6%, p\<0.004), time to physician initial assessment (PIA) (104.3 minutes to 42.2 minutes, p\<0.001), and length of stay in the ED (LOS) (199.4 minutes to 134.4 minutes p\<0.002).
The investigators plan to implement and evaluate SurgeCon in other hospitals in Newfoundland and Labrador (NL) to determine whether these results can be reproduced in urban and other rural EDs. SurgeCon will be considered a completely successful intervention if it requires minimal resources from the ED/health system for its continued operation, improves patient satisfaction and outcomes, and creates better value ED services by reducing the cost of providing the services. The payer organization that will be a rewarding success is the Eastern Health regional health authority (EH) in NL. As the largest health authority in NL, EH is a key organization for the delivery of care and setting provincial standards. It is responsible for managing both rural and urban hospitals and reflects the diversity of institutions across the rest of Canada.
SurgeCon's evaluation and implementation strategy will include a four-stage iterative process: 1. Exploration (month 1-10); 2. Adoption (months 11-12, 17-18, 23-24 and 29-30); 3. Active Implementation (months 13-36); 4. Sustainment (months 19-48). To measure success, the investigators will use an innovative comparative effectiveness implementation hybrid design. The investigators will test the effects of SurgeCon on ED key performance indicators (LOS, PIA, and LWBS) and patient-reported experiences (PREMs), while also capturing data related to its implementation across participating EDs. Our innovative clinical trial (iCT) design will test the effectiveness of SurgeCon using a pragmatic stepped wedge cluster randomized controlled trial accompanied by a cost-effectiveness analysis. Our stepped-wedge iCT design will assign each hospital to a step through a random ordering process. In addition to ED key performance indicators (KPI) and PREMs, the investigators will also measure implementation outcomes related to SurgeCon's scalability, adaptability, sustainability and overall costs. Implementation outcomes will be evaluated by patients, providers/staff and health system managers using a mixed methods process. The hybrid evaluation/implementation design represents an integrated knowledge translation approach that will ensure research findings are eventually integrated into policy and practice. Moreover, a multidisciplinary research team including patient partners, decision-makers, frontline clinicians, and researchers will lead this research.
Conditions
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Study Design
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RANDOMIZED
CROSSOVER
HEALTH_SERVICES_RESEARCH
NONE
Study Groups
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Hospital site 1
This site will provide usual ED care during the control period which will last for the first six months of the study. After six months this site will begin transitioning to the SurgeCon management platform which they will use until the end of the study.
SurgeCon
The SurgeCon intervention is a pragmatic ED management platform that includes three distinct intervention components which include 1) Restructuring ED Organization \& Workflow, 2) Establishing a Patient-Centric ED Environment, and 3) E-Health Action-Based ED Management that together act to improve ED efficiency and patient satisfaction and value of care.
Hospital site 2
This site will provide usual ED care during the control period which will last for the first 12 months of the study. After 12 months this site will begin transitioning to the SurgeCon management platform which they will use until the end of the study.
SurgeCon
The SurgeCon intervention is a pragmatic ED management platform that includes three distinct intervention components which include 1) Restructuring ED Organization \& Workflow, 2) Establishing a Patient-Centric ED Environment, and 3) E-Health Action-Based ED Management that together act to improve ED efficiency and patient satisfaction and value of care.
Hospital site 3
This site will provide usual ED care during the control period which will last for the first 18 months of the study. After 18 months this site will begin transitioning to the SurgeCon management platform which they will use until the end of the study.
SurgeCon
The SurgeCon intervention is a pragmatic ED management platform that includes three distinct intervention components which include 1) Restructuring ED Organization \& Workflow, 2) Establishing a Patient-Centric ED Environment, and 3) E-Health Action-Based ED Management that together act to improve ED efficiency and patient satisfaction and value of care.
Hospital site 4
This site will provide usual ED care during the control period which will last for the first 24 months of the study. After 24 months this site will begin transitioning to the SurgeCon management platform which they will use until the end of the study.
SurgeCon
The SurgeCon intervention is a pragmatic ED management platform that includes three distinct intervention components which include 1) Restructuring ED Organization \& Workflow, 2) Establishing a Patient-Centric ED Environment, and 3) E-Health Action-Based ED Management that together act to improve ED efficiency and patient satisfaction and value of care.
Interventions
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SurgeCon
The SurgeCon intervention is a pragmatic ED management platform that includes three distinct intervention components which include 1) Restructuring ED Organization \& Workflow, 2) Establishing a Patient-Centric ED Environment, and 3) E-Health Action-Based ED Management that together act to improve ED efficiency and patient satisfaction and value of care.
Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
ALL
No
Sponsors
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Canadian Institutes of Health Research (CIHR)
OTHER_GOV
Government of Newfoundland and Labrador
OTHER_GOV
Eastern Health
OTHER
Trinity Conception Placentia Health Foundation
UNKNOWN
Memorial University of Newfoundland
OTHER
Responsible Party
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Shabnam Asghari
Professor
Principal Investigators
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Shabnam Shabnam, PhD
Role: PRINCIPAL_INVESTIGATOR
Memorial University of Newfoundland
Locations
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Burin Peninsula Healthcare Centre
Burin, Newfoundland and Labrador, Canada
Dr. G.B. Cross Memorial Hospital
Clarenville, Newfoundland and Labrador, Canada
Health Sciences Centre
St. John's, Newfoundland and Labrador, Canada
St. Clare's Mercy Hospital
St. John's, Newfoundland and Labrador, Canada
Countries
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References
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Anaraki NR, Mukhopadhyay M, Jewer J, Patey C, Norman P, Hurley O, Etchegary H, Asghari S. A qualitative study of the barriers and facilitators impacting the implementation of a quality improvement program for emergency departments: SurgeCon. BMC Health Serv Res. 2024 Jul 27;24(1):855. doi: 10.1186/s12913-024-11345-w.
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Related Links
Access external resources that provide additional context or updates about the study.
Canadian Institute for Health Information. Emergency department wait times in Canada continuing to rise
BBC News. Dramatic rise in waiting times at emergency departments
How long is too long to wait in an emergency room?
The Commonwealth Fund. The commonwealth fund 2010 international health policy survey in eleven countries.
CBC News. Labrador senior waits 10 hours in emergency room without care for broken arm.
CBC News. Picture of senior waiting for hours in St. John's emergency room sparks outrage.
CBC News. St. Anthony patients kept on stretchers while beds remained in storage.
Canadian Institute for Health Information. PROMS background document.
Canadian Institute for Health Information. Patient experience
Lean Production. Kaizen
Other Identifiers
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SR4-165123
Identifier Type: OTHER_GRANT
Identifier Source: secondary_id
20201482
Identifier Type: -
Identifier Source: org_study_id
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