EmergenciesMDRNSTATNCT00991471
The Effect of an Physician-Nurse Supplementary Triage Assistance Team on Emergency Department Patient Wait Times
A study testing Interaction with MDRN STAT and No MDRNSTAT in people with Emergencies, run by Sunnybrook Health Sciences Centre at 1 site in Canada.
Trial summary
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. Read more about this study
- Who is it for?
- Any ageHealthy volunteers can take part
- Conditions the study is for
- Emergencies
- What is being tested?
- Interaction with MDRN STAT and No MDRNSTAT
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 6,300 participants
- Where
- 1 siteCanada
- Study dates
- Sep 2009to Feb 2010
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- Healthy volunteers accepted
- Child, Adult, Older adult
Who may be able to join
- Patients arriving from 8:00-14:30 during a day here a MDRN STAT is assigned
Who cannot join
- None
Trial locations and contacts
1 site in 1 country.
About this study
Official title: A Cluster Randomized Trial of the Effect of an Physician-Nurse Supplementary Triage Assistance Team (MDRN STAT) on Emergency Department Patient Wait Times
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
Read the detailed 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.
- Conditions
- Emergencies
- Being tested
- Interaction with MDRN STAT, No MDRNSTAT
- Keywords
- Emergency Department Wait Times, Physician Nurse at Triage, Overcrowding, CostEffectiveness
- Medical subject headings
- Emergencies, Crowding
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Interaction with MDRN STATBehavioural
Interaction with MDRNSTAT at triage to obtain orders for investigations and/or treatment
No MDRNSTATBehavioural
Also called Standard triage
Standard management of nurse-only triage for assignment of CTAS
| Study group | Role | What they receive |
|---|---|---|
| Interaction with MDRN STAT | Experimental | Interaction with MDRNSTAT at triage to obtain orders for investigations and/or treatment Receives: Behavioral: Interaction with MDRN STAT |
| Control: No MDRNSTAT | Experimental | Control group Receives: Behavioral: No MDRNSTAT |
What is being measured
The primary outcome is the main question the study is designed to answer.
Effectiveness of the MDRN STAT on emergency department wait times
Measured: Time from triage to time of discharge from ED
Secondary outcomes (1)
Cost-Effectiveness of a MDRN STAT in the Emergency Department
Measured: 6 months, of 50 MDRN STAT shifts, randomized with non-intervention
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 Oct 2009 (estimated)
- Study startSep 2009
- Primary completionFeb 2010
- Study completionFeb 2010
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for EmergenciesStudies of the same condition, open and under way.
- More trials run by Sunnybrook Health Sciences CentreThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 6,300 participants (actual)
Sponsor and investigators
- Lead sponsor
- Sunnybrook Health Sciences Centre
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Ivy Cheng, Sunnybrook Health Sciences Centre
- Investigators
- Ivy Cheng, FRCP, Principal investigator, Sunnybrook Hospital Emergency Department
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00991471
- Sponsor's protocol ID
- 226-2009
- Acronym
- MDRNSTAT
- Status last verified
- Oct 2017
- First submitted
- 5 Oct 2009
- Last updated
- 31 Oct 2017
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Cheng I, Lee J, Mittmann N, Tyberg J, Ramagnano S, Kiss A, Schull M, Kerr F, Zwarenstein M. Implementing wait-time reductions under Ontario government benchmarks (Pay-for-Results): a Cluster Randomized Trial of the Effect of a Physician-Nurse Supplementary Triage Assistance team (MDRNSTAT) on emergency department patient wait times. BMC Emerg Med. 2013 Nov 11;13:17. doi: 10.1186/1471-227X-13-17.
PubMed 24207160
Study at a glance
From the registry record, last updated by the sponsor on 31 Oct 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Cluster Randomized Trial of the Effect of an Physician-Nurse Supplementary Triage Assistance Team (MDRN STAT) on Emergency Department Patient Wait Times
- ClinicalTrials.gov ID
- NCT00991471
- Acronym / sponsor ID
- MDRNSTAT / 226-2009
- Conditions
- Emergencies
- Keywords
- Emergency Department Wait Times, Physician Nurse at Triage, Overcrowding, CostEffectiveness
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 6,300 participants (actual)
- Lead sponsor
- Sunnybrook Health Sciences CentreUniversity, hospital or other
- Study start
- Sep 2009
- Primary completion
- Feb 2010 (actual)
- Study completion
- Feb 2010 (actual)
- First posted
- 8 Oct 2009 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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
Detailed 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.
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Interaction with MDRN STAT | Experimental | Behavioral: Interaction with MDRN STATInteraction with MDRNSTAT at triage to obtain orders for investigations and/or treatment |
| Control: No MDRNSTAT | Experimental | Behavioral: No MDRNSTATControl group |
Who may qualify
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (1 listed)
- Patients arriving from 8:00-14:30 during a day here a MDRN STAT is assigned
Key exclusion criteria (1 listed)
- None
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Interaction with MDRN STATInteraction with MDRNSTAT at triage to obtain orders for investigations and/or treatment | Behavioural | Interaction with MDRN STAT |
| No MDRNSTATAlso: Standard triageStandard management of nurse-only triage for assignment of CTAS | Behavioural | Control: No MDRNSTAT |
Primary outcome
Effectiveness of the MDRN STAT on emergency department wait times
Time frame: Time from triage to time of discharge from ED
1 secondary outcome
Cost-Effectiveness of a MDRN STAT in the Emergency Department
Time frame: 6 months, of 50 MDRN STAT shifts, randomized with non-intervention
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 31 Oct 2017.
- Derived from this study: PubMed 24207160Cheng I, Lee J, Mittmann N, Tyberg J, Ramagnano S, Kiss A, Schull M, Kerr F, Zwarenstein M. Implementing wait-time reductions under Ontario government benchmarks (Pay-for-Results): a Cluster Randomized Trial of the Effect of a Physician-Nurse Supplementary Triage Assistance team (MDRNSTAT) on emergency department patient wait times. BMC Emerg Med. 2013 Nov 11;13:17. doi: 10.1186/1471-227X-13-17.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Ivy Cheng, FRCP principal investigator
Sunnybrook Hospital Emergency Department
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Interaction with MDRN STAT and No MDRNSTAT in people with Emergencies, run by Sunnybrook Health Sciences Centre at 1 site in Canada.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 31 Oct 2017. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Effectiveness of the MDRN STAT on emergency department wait times (time frame: Time from triage to time of discharge from ED). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00991471, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 31 Oct 2017.