RecruitingACTRN12619000665134

A multicentre, qualitative evaluation of the impact of advertised Emergency Department (ED) wait time on ED patients, potential patients and other stakeholders.

Sponsor

Dr Michael Ben-Meir

Enrollment

50 participants

Start Date

Jun 13, 2019

Study Type

Observational

Conditions

Published Emergency Department wait times Private Emergency Medicine Emergency Medicine

Summary

The decision to seek out emergency medical care is complex and nuanced. Many factors influence what care to seek and when. Once a facility or provider is chosen, there will be expectations for care competency and timeliness. Acutely unwell or distressed patients hope to see a Health Clinician or Doctor immediately on arrival, however this is rarely achievable. The reality for most patients is that they join a queue for care and wait to be treated. Previously, community health providers and patients have been blinded to the length of those queues. In the era of expanding Information Technology (IT) capabilities, advertised Emergency Department (ED) wait times (real-time, available on the internet) have recently been posted in Australia, including Cabrini ED’s time to see a doctor. There is a paucity of information regarding the impact of this on patients, paramedics and community members. The goal of the study is to explore the potential impact of advertised ED wait times by interviewing consumers and potential consumers of this information. Through this exploration, we hope to provide insight into the positive and negative aspects of this tool, allowing health administrators to determine whether and how to deploy the information. This study will be a prospective, multicentre, qualitative study collecting data via semi-structured interviews with patients (or guardians), paramedics and community members. It will be conducted over 3 months at Cabrini Hospital, Monash Medical Centre and Box Hill emergency departments. Community members (Bolton-Clarke consumers, sports club members and community representatives) will be interviewed either face to face or via telephone. The interviews will be recorded and transcribed. All data will be analysed and a descriptive paper submitted to various biomedical journals. This study aims to explore the impact of advertised ED wait times which may influence future policy decisions, the structure and deployment of wait time information and ongoing wait time and IT metadata application research.

Eligibility

Sex: Both males and femalesMin Age: 18 Yearss

Plain Language Summary

Simplified for easier understanding

This study is exploring how publicly displayed emergency department (ED) wait times — which some Australian hospitals now post online in real time — affect the decisions and experiences of patients, paramedics, and community members. The ability to check how long the wait is before deciding where to go for emergency care is a new phenomenon, and its impact on patient behaviour and health outcomes is poorly understood. Researchers will conduct semi-structured interviews with people currently waiting in the emergency department, paramedics who bring patients to EDs, and community members (such as sports club members and aged care clients). Interviews will be conducted at Cabrini Hospital, Monash Medical Centre, and Box Hill Hospital over three months, and some community members will be interviewed by phone. You may be eligible if you are an adult currently waiting in the ED (or your guardian is), a paramedic accompanying a patient, or a community member willing to share your views. People who are too unwell, significantly distressed, unable to consent, or whose participation would delay their care are not eligible. The study aims to inform health administrators about whether and how to publish this type of information in the future.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

Patients who attend emergency departments usually wait to be treated. This is called the emergency department wait time. This study is a qualitative exploration of the patient and stakeholder/referrer experience of waiting to see a doctor or nurse and whether there is value in providing approximate wait times to people (online access and waiting room access). It will also explore what people's interpretation of the meaning of wait time (and patient's interpretations of what constitutes treatment) and whether this is important information to consumers. At a few facilities nationally and internationally, there is online streaming of predictive wait time information made available to patients and referrers. This is sometimes called the advertised wait time. (e.g. Cabrini Emergency Department, approximate wait time to be seen by a doctor = 33 minutes, patients waiting to be seen = 4). Most facilities in Australia currently aren't making patient wait times available in this manner. When advertised wait times are available and provided by individual hospitals (or state departments of health), they can be accessed online on hospital/health department websites and are sometimes displayed in patient waiting rooms. e.g. https://www.cabrini.com.au/patients-and-families/services/directory/emergency-department Predictive information is generated by using previous and current patient administrative metadata (previous patient wait times) and calculated by complex mathematical algorithms. There is little data currently available regarding the accuracy of algorithms. Most patients and consumers in this study will not have access to this type of data for their local hospital. A few will have attended a hospital where predicted wait times are displayed. Patient and stakeholder/referrer interviews will be undertaken to explore a number of aspects related to wait times. We anticipate that interviews will take between 10 and 20 minutes per face-to-face or phone interview. There will be only one interview for each subject. Patients in Emergency Departments will be asked: what wait times mean to them, whether it is important to patients to have approximate wait times available to them at point of care/need, how wait time information should be displayed and aspects of safety regarding wait times will be explored. Paramedics/Ambulance Victoria controllers/diversion officers will be asked: what they perceive wait times to be, whether it is important to have approximate wait times available, whether this may facilitate load sharing, how wait times should be displayed and aspects of safety regarding wait times will be explored. Consumer representatives will be asked: what wait times mean to them, whether it is important to patients to have approximate wait times available to them at point of care/need, how wait time information should be displayed and aspects of safety regarding wait times will be explored. Health administrators will be asked: what wait times mean to them, any potential enablers or barriers, how wait time information should be displayed and aspects of safety regarding wait times will be explored.