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Completed

NCT Number: NCT05974787

Potential Improvements in the Pre-emergency Department Care for Cancer Patients

The goal of this single center prospective cross-sectional study is to identify the facilitators and barriers in the course of the disease that starts when symptoms first arise until patients with solid and hematologic malignancies arrive in the emergency department (ED). The main question it aims to answer are: Is there a potential relation between the lag-time and the ED length of stay (LOS) and the chance of admission. Participants will be asked to participate in a one-time interview, that focusses on the pre-admission process.

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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 single center prospective cross-sectional study is to identify the facilitators and barriers in the course of the disease that starts when symptoms first arise until patients with solid and hematologic malignancies arrive in the emergency department (ED). The main question it aims to answer are: Is there a potential relation between the lag-time and the emergency department length of stay and the chance of admission. Participants will be asked to participate in a one-time interview, that focusses on the pre-admission process. The interview focuses on several parts of the (pre-)admission process: The first part is regarding the timeline that led to an ED visit. The investigators will establish, when and which symptoms were first detected. The second part are regarding the number and type of health care workers that were contacted before visiting the ED. The third part will be about the actions that were taken before the ED visit.

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 systemic 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 48 hours after presentation at the emergency department (ED).

Exclusion criteria

  • <18 years old
  • Only received a surgical intervention as cancer treatment
  • Admitted to the ED for the surgical department
  • Not willing or able to give written informed consent

Treatment and study plan

Emergency department cancer patients interview

Behavioral

The interview focuses on several parts of the (pre-)admission process: The first part is regarding the barriers and facilitators encountered during the (pre-)admission process. The second part will focus on the timeline that led to an emergency department (ED) visit. It will be established when and which symptoms were first detected. The third part is regarding the number and type of health care workers that were contacted before visiting the ED. The fourth part will be about the actions and considerations taken before the ED visit.

Primary outcomes

  1. Clusters of facilitators experienced by cancer patients.

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

    Different (sub)clusters of facilitators experienced by cancer patients visiting the emergency department (ED)

  2. clusters of barriers experienced by cancer patients.

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

    Different (sub)clusters of barriers experienced by cancer patients visiting the ED

Secondary outcomes

  1. Time-to-speak

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

    The time between the first notice of symptoms and the first time these complaints were spoken out to the primary giver

  2. Time-to-contact

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

    The time between the first time complaints are spoken out and contact is made with a healthcare professional

  3. Time-to-present

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

    The time between the first contact with a healthcare professional and the presentation at the ED

  4. Difference in group average lag-time between day, evening and night

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

    Difference in group average lag-time between day, evening and night

  5. Difference in group average lag-time between weekdays (Monday 08:00 till Friday 23:59) and weekend (Saturday 00:00 and Monday 7:59)

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

    Difference in group average lag-time between weekdays (Monday 08:00 till Friday 23:59) and weekend (Saturday 00:00 and Monday 7:59)

  6. Correlation between number of contacted healthcare providers before presentation at the ED and the lag- time.

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

    Correlation between number of contacted healthcare providers before presentation at the ED and the lag- time.

  7. Willingness to participate

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

    the percentage of people that participated in this study in comparison to the people approached for this study.

  8. Lag-time

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

    The time between the first onset of symptoms and a visit to the ED.

  9. ED length of stay (LOS)

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

    The time a patient spends in the ED

  10. Disposition

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

    The outcome of a visit to the ED, being either admission or home

  11. Patient characteristics

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

    Age, sex, type of cancer, type of complaint, triage category, number of prior visits

  12. Correlation between lag-time and ED-LOS

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

    Correlation between lag-time and ED-LOS

  13. Correlation between lag-time and disposition

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

    Correlation between lag-time and disposition

  14. Correlation between lag-time and patient characteristics

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

    Correlation between lag-time and patient characteristics

  15. ED crowding

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

    Measure of business of the ED, composed of the number of patients in the ED and the color coding used for crowding

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 - I Trial)

Acronym: OVERSEE-I

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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