ED Adaptive Staffing Study

NCT05937763 | Recruiting

• 1 other identifier: 148-2306
• Study Type: observational
• Target: 5,917
• Locations: 1 country
• Sites: 1

Brief Summary

Emergency Departments (EDs) across Ontario are being inundated with unprecedented high patient volumes and a staffing shortage that directly impacts patient care and flow. An area of concern among EDs is the offload zone where patients are brought in by ambulance. EMS offload time is the time it takes paramedics to transfer a patient to the appropriate area within an emergency department and give hospital staff a summary of what concerns the patient is seeking care for. There are multiple factors that may delay this time, including limited staff in the offload area to complete the transfer process due to competing patient care responsibilities. The adaptive staffing model study will look to add a primary care paramedic (PCP) or a registered nurse (RN) in the offload zone during times of high ambulance volume (August to January) to help with patient care within the offload zone. This single-centered community hospital study will evaluate the benefits of having a PCP or RN, compared to the current model, on ambulance offload times, patient safety outcomes, patient treatment times, and staff well-being using three different models of staffing.

Conditions

Emergency Medicine; Well-Being, Psychological

Outcome Measures

Primary Outcomes (2)

• Triage Time

  The aim of this objective is to compare time to triage and time to transfer of care for three models of staffing.

  6 months

• Return to Service

  The aim of this objective is to determine if an adaptive staffing model during peak volumes reduces ambulance offload times and return to service.

  6 months

Secondary Outcomes (7)

• Time to provider assessment

  6 months

• Provider Feedback Survey

  6 months

• Time to treatment

  6 months

• Time to disposition

  6 months

• Number of incident reports

  6 months

Study Arms (3)

Primary Care Paramedic (PCP) Block

A PCP will be staffed in the emergency department offload zone 3 days a week (Monday, Wednesday, and Friday) on a 10am - 10pm shift, in addition to the standard staffing model.

Other: Staffing model

Registered Nurse (RN) Block

An experienced emergency department RN with triage training will be staffed in the emergency department offload zone 3 days a week (Monday, Wednesday, and Friday) in a 10am - 10pm shift, in addition to the standard staffing model

Other: Staffing model

Current Workflow Block

The currently hospitals staffing models of the emergency department offload zone.

Interventions

Staffing model OTHER

Staffing the hospitals emergency department offload zone with a PCP or RN or current workflow.

Primary Care Paramedic (PCP) Block; Registered Nurse (RN) Block

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study will use a convenience sampling method, given that patients brought in by ambulance are at random and non-predictive.

You may qualify if:

• Patients brought in by ambulance to hospitals emergency department offload area

You may not qualify if:

• Patients not arriving to the hospitals emergency department offload area

Sponsors & Collaborators

• Oak Valley Health: lead

Study Sites (1)

Markham Stouffville Hospital

Markham, Ontario, L3P 7P3, Canada

RECRUITING

MeSH Terms

Conditions

Psychological Well-Being

Condition Hierarchy (Ancestors)

Personal Satisfaction; Behavior

Central Study Contacts

Andrew Arcand, MD

CONTACT

905-472-7373; AArcand@oakvalleyhealth.ca

Michelle Dimas, MSc

CONTACT

905-472-7373; mdimas@oakvalleyhealth.ca

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 23, 2023
• First Posted: July 10, 2023
• Study Start: October 2, 2023
• Primary Completion: March 1, 2024
• Study Completion: September 1, 2024
• Last Updated: March 22, 2024

Record last verified: 2024-03

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)