Clinical trial NCT05974800: Potential Improvements in Emergency Department Care for Cancer Patients According to Clinical Staff
Official title: Identification of Potential Improvements in the Acute Care Pathway for Cancer Patients in the Emergency Department (OVERSEE - II Trial)
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Cancer
Emergencies
Lead sponsor: Erasmus Medical Center
Sponsor class: OTHER
First posted: 2023-08-03
Enrollment: 59
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: In the emergency department (ED) of Erasmus medical center (MC) yearly around 1600 patients with cancer are presented to the ED. Based on the study design we will conduct interviews with 75 to 100 patients with solid and hematologic malignancies, who are receiving systemic therapy or have received systemic therapy within the last 3 months and are admitted to the ED department of the Erasmus MC for the oncology, hematology, lung- and neuro-oncology medical unit. If present, the interview will also be held with the family caregiver.

Brief summary: 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).

Detailed description: 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.

Eligibility criteria: 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.

Primary outcomes:
measure: Clusters of facilitator and barriers identified by the emergency department (ED) nurse
timeFrame: Through study completion, an average of 6 months
measure: Clusters of facilitator and barriers identified by the treating physician
timeFrame: Through study completion, an average of 6 months
measure: Clusters of facilitator and barriers identified by the supervising physician
timeFrame: Through study completion, an average of 6 months
Secondary outcomes:
measure: Emergency department (ED) length of stay (LOS)
timeFrame: Through study completion, an average of 6 months
measure: Disposition
timeFrame: Through study completion, an average of 6 months
measure: Correlation between ED-LOS and disposition
timeFrame: Through study completion, an average of 6 months
measure: Years of medical experience
timeFrame: Through study completion, an average of 6 months
measure: Need for imaging
timeFrame: Through study completion, an average of 6 months
measure: ED nurse agreement of disposition
timeFrame: Through study completion, an average of 6 months
measure: Attending physician agreement of disposition
timeFrame: Through study completion, an average of 6 months
measure: Supervising physician agreement of disposition
timeFrame: Through study completion, an average of 6 months
measure: Time-to-disposition
timeFrame: Through study completion, an average of 6 months
measure: Time-to-ward
timeFrame: Through study completion, an average of 6 months
measure: Correlation between time-to-disposition and the ED-LOS
timeFrame: Through study completion, an average of 6 months
measure: Correlation between time-to-ward and the ED-LOS
timeFrame: Through study completion, an average of 6 months
measure: Difference in categories
timeFrame: Through study completion, an average of 6 months
measure: ED nurse summary of actions
timeFrame: Through study completion, an average of 6 months
measure: Attending physician summary of actions
timeFrame: Through study completion, an average of 6 months
measure: Supervising physician summary of actions
timeFrame: Through study completion, an average of 6 months
measure: ED crowding
timeFrame: Through study completion, an average of 6 months
measure: Difference in clusters per group between day, evening and night
timeFrame: Through study completion, an average of 6 months
measure: Difference in clusters per group between weekdays and weekend
timeFrame: Through study completion, an average of 6 months
Other outcomes:
measure: Patient characteristics
timeFrame: Through study completion, an average of 6 months
Locations:
city: Rotterdam
country: Netherlands
facility: Erasmus MC
state: Zuid-Holland
Study officials:
affiliation: Erasmus Medical Center
name: Jason den Duijn
role: PRINCIPAL_INVESTIGATOR
References: