Medical Checklists in the Emergency Department

Study Overview
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Brief Summary
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This study aims to investigate whether the use of medical checklists in the emergency department can decrease resuscitation time in critically ill patients.

Detailed Description
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A scenario evaluating tricyclic antidepressant poisoning will be carried out with and without medical checklist access. Emergency physicians from the Netherlands who are willing to take part in the study are randomly allocated to perform the scenario with or without checklists.

Official Title
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The Impact of Medical Checklists on the Management of Acute Situations in the Emergency Department. A Simulation-based Randomised Controlled Trial.

Conditions
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Emergencies, Tricyclic Antidepressant Poisoning, Tricyclic Antidepressant Toxicity

Intervention / Treatment
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* Device: Checklist


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Emergency Physicians recognised by KNMG (Koninklijke Nederlandsche Maatschappij tot bevordering van de Geneeskunst) working in the Netherlands Exclusion Criteria: Residents (in Dutch: AIOS) Emergency Medicine Interns (in Dutch: ANIOS) Emergency Medicine
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Participants (emergency physicians) will be allocated to performing the scenario with or without checklist in a randomized fashion on a 1:1 ratio. Computerized randomization will take place using an online randomization module.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention group: with checklist<br>When starting the scenario, a checklist will be given to the emergency physician. The checklist outlines interventions to consider during management of a patient with tricyclic antidepressant poisoning. Each checklist will include indications, contra-indications and for medication, dose, route and rate of administration. | Device: Checklist<br>* A checklist is an aid that outlines assessments or actions systematically. In this study, the checklist outlines interventions to consider during management of a patient with tricyclic antidepressant poisoning. Each checklist will include indications, contra-indications and for medication, dose, route and rate of administration.<br>|
| No Intervention: Control group: without checklist<br>Emergency physicians will be asked to perform the scenario as they would in their daily practice. They will be allowed to use their usual cognitive aids (eg, phone, internet) but not allowed to request help from others. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Duration of the scenario | The primary outcome is the duration of primary resuscitation utilizing the checklists versus treatment on discretion of the treating physician. The simulation will be terminated when all indicated interventions are performed, when the team expresses that they cannot think of any other intervention to perform or when 15 minutes have elapsed. | Through study completion, indicated 10 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of indicated interventions performed by the emergency physician | Based on the checklist, a number of predefined indicated interventions is established. When reviewing the video recordings, it will be noted whether indicated interventions were performed and when these interventions were performed. The order according to which interventions are performed will not impact on this secondary outcome. | Through study completion, indicated 10 months | 
| Satisfaction of emergency physicians with the checklists | Participants, who run the scenarios with checklist access, will be asked to fill out a questionnaire evaluating the checklist (5-point Likert scales). | Through study completion, indicated 10 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Medical checklists