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Completed

NCT Number: NCT05974800

Potential Improvements in Emergency Department Care for Cancer Patients According to Clinical Staff

The goal of this Single center prospective cross-sectional study is to identify the facilitators and barriers among caregivers in the emergency department that influence disposition of patients with solid and hematology malignancies. The main question it aims to answer is to categorize the facilitators and barriers identified by three groups of emergency department (ED) staff. Participants will be asked for permission, afterwards a short interview will be held with the different ED caregivers (ED nurse, attending physician and supervising physician).

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Key information

Conditions

Cancer Disease Attributes Emergencies Neoplasms Pathologic Processes Pathological Conditions, Signs and Symptoms

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Erasmus MC

Rotterdam, South Holland, 3015GD, Netherlands

About this study

The goal of this to identify the facilitators and barriers among caregivers in the emergency department (ED) that influence disposition of patients with solid and hematology malignancies. Participants will be asked for permission, afterwards a short interview will be held with the different caregivers (ED nurse, attending physician and supervising physician) in the ED. The interviews will be held in the order of the ED care pathway, meaning ED nurse first, treating physician second and supervising physician at last. The interviews will be conducted for every patient with each of the caregivers. Each interview will be conducted after the caregiver has made the first examination of the patient. The interview focuses on several parts of the emergency care process: The first part is regarding the actions that are executed during an ED visit. We will establish which actions are executed and why. The second part is regarding the suspected outcome for the patient. The third part will be about any potential improvements to the emergency care process for the patient.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients with solid or hematological malignancies and receiving system therapy or having received systemic therapy within the last 3 months.
  • Presented at or admitted from the emergency department for the oncology, hematology, neuro- or lung-oncology clinical unit.
  • Awake and conscious.
  • Possible to answer questions within the same shift / day after presentation in the ED.

Exclusion criteria

  • <18 years old.
  • Only received a surgical intervention as cancer treatment.
  • Not willing or able to give written informed consent.

Treatment and study plan

Emergency department caregivers interview

Behavioral

The interview focuses on several parts of the emergency care process: The first part is regarding the actions that are executed during an emergency department visit. We will establish which actions are executed and why. The second part is regarding the suspected outcome for the patient. The third part will be about any potential improvements to the emergency care process for the patient.

Primary outcomes

  1. Clusters of facilitator and barriers identified by the emergency department (ED) nurse

    Time frame: Through study completion, an average of 6 months

    (Sub)Clusters of facilitator and barriers identified by the ED nurse for the ED care of patients with cancer

  2. Clusters of facilitator and barriers identified by the treating physician

    Time frame: Through study completion, an average of 6 months

    (Sub)Clusters of facilitator and barriers identified by the treating physician for the ED care of patients with cancer

  3. Clusters of facilitator and barriers identified by the supervising physician

    Time frame: Through study completion, an average of 6 months

    (Sub)Clusters of facilitator and barriers identified by the supervising physician for the ED care of patients with cancer

Secondary outcomes

  1. Emergency department (ED) length of stay (LOS)

    Time frame: Through study completion, an average of 6 months

    Emergency department length of stay

  2. Disposition

    Time frame: Through study completion, an average of 6 months

    Outcome after ED admission, being home or admission

  3. Correlation between ED-LOS and disposition

    Time frame: Through study completion, an average of 6 months

    Correlation between ED-LOS and disposition

  4. Years of medical experience

    Time frame: Through study completion, an average of 6 months

    Number of years a medical staffmember is working in health care

  5. Need for imaging

    Time frame: Through study completion, an average of 6 months

    Was imaging ordered during ED visit and which kind

  6. ED nurse agreement of disposition

    Time frame: Through study completion, an average of 6 months

    Agreement between ED nurse expected disposition and the actual disposition

  7. Attending physician agreement of disposition

    Time frame: Through study completion, an average of 6 months

    Agreement between treating physician expected disposition and the actual disposition

  8. Supervising physician agreement of disposition

    Time frame: Through study completion, an average of 6 months

    Agreement between supervising physician expected disposition and the actual disposition

  9. Time-to-disposition

    Time frame: Through study completion, an average of 6 months

    The time between patient's arrival at the ED and the decision to disposition

  10. Time-to-ward

    Time frame: Through study completion, an average of 6 months

    The time between the decision to hospitalize and the arrival at the ward

  11. Correlation between time-to-disposition and the ED-LOS

    Time frame: Through study completion, an average of 6 months

    Correlation between time-to-disposition and the ED-LOS

  12. Correlation between time-to-ward and the ED-LOS

    Time frame: Through study completion, an average of 6 months

    Correlation between time-to-ward and the ED-LOS

  13. Difference in categories

    Time frame: Through study completion, an average of 6 months

    The difference in the percentages in categories between the different caregivers

  14. ED nurse summary of actions

    Time frame: Through study completion, an average of 6 months

    Summary of actions taken by ED nurse in the ED care for patients with cancer

  15. Attending physician summary of actions

    Time frame: Through study completion, an average of 6 months

    Summary of actions taken by attending physician in the ED care for patients with cancer

  16. Supervising physician summary of actions

    Time frame: Through study completion, an average of 6 months

    Summary of actions taken by supervising physician in the ED care for patients with cancer

  17. ED crowding

    Time frame: Through study completion, an average of 6 months

    Degree of crowding in the ED, consisting of number of patients in the ED and the ED crowding color code

  18. Difference in clusters per group between day, evening and night

    Time frame: Through study completion, an average of 6 months

    Difference in clusters per ED staff group between day, evening and night

  19. Difference in clusters per group between weekdays and weekend

    Time frame: Through study completion, an average of 6 months

    Difference in clusters per group between weekdays (Monday 08:00 till Friday 16:00) and weekend (Friday 16:01 till Monday 7:59)

Other outcomes

  1. Patient characteristics

    Time frame: Through study completion, an average of 6 months

    age, sex, type of cancer, type of treatment, main complaint, triage category, number of prior ED visits.

Sponsors and collaborators

Lead sponsor

Erasmus Medical Center

Other

Registry information

Official study title

Identification of Potential Improvements in the Acute Care Pathway for Cancer Patients in the Emergency Department (OVERSEE - II Trial)

Acronym: OVERSEE-II

Important dates

Study start
2024
Primary completion
2024
Study completion
2024
First posted
Aug 3, 2023
Registry last updated
Oct 15, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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