Ignite Creation Date:
2025-12-25 @ 2:50 AM
Ignite Modification Date:
2026-01-06 @ 8:35 AM
Study NCT ID:
NCT03185533
Status:
COMPLETED
Last Update Posted:
2017-06-14
First Post:
2017-06-04
Is NOT Gene Therapy:
True
Has Adverse Events:
False
Brief Title:
Reducing Length of Stay in the Emergency Department
Sponsor:
Organization:
Raw JSON
{'hasResults': False, 'derivedSection': {'miscInfoModule': {'versionHolder': '2025-12-24'}, 'interventionBrowseModule': {'meshes': [{'id': 'D058996', 'term': 'Quality Improvement'}, {'id': 'D008722', 'term': 'Methods'}], 'ancestors': [{'id': 'D004738', 'term': 'Engineering'}, {'id': 'D013676', 'term': 'Technology, Industry, and Agriculture'}, {'id': 'D011787', 'term': 'Quality of Health Care'}, {'id': 'D006298', 'term': 'Health Services Administration'}, {'id': 'D008919', 'term': 'Investigative Techniques'}]}}, 'protocolSection': {'designModule': {'studyType': 'OBSERVATIONAL', 'designInfo': {'timePerspective': 'PROSPECTIVE', 'observationalModel': 'CASE_ONLY'}, 'enrollmentInfo': {'type': 'ACTUAL', 'count': 72000}, 'patientRegistry': False}, 'statusModule': {'overallStatus': 'COMPLETED', 'startDateStruct': {'date': '2015-01-01', 'type': 'ACTUAL'}, 'expandedAccessInfo': {'hasExpandedAccess': False}, 'statusVerifiedDate': '2017-06', 'completionDateStruct': {'date': '2015-12-31', 'type': 'ACTUAL'}, 'lastUpdateSubmitDate': '2017-06-10', 'studyFirstSubmitDate': '2017-06-04', 'studyFirstSubmitQcDate': '2017-06-10', 'lastUpdatePostDateStruct': {'date': '2017-06-14', 'type': 'ACTUAL'}, 'studyFirstPostDateStruct': {'date': '2017-06-14', 'type': 'ACTUAL'}, 'primaryCompletionDateStruct': {'date': '2015-12-31', 'type': 'ACTUAL'}}, 'outcomesModule': {'primaryOutcomes': [{'measure': 'length of stay for ED admissions.', 'timeFrame': '12 months', 'description': 'Length of stay was defined as the time from patient registration to leaving the ED.'}], 'secondaryOutcomes': [{'measure': 'boarding time for ED admissions', 'timeFrame': '12months', 'description': 'Boarding time was defined as the time from decision for admission to leaving the ED.'}, {'measure': 'decision time for ED admissions', 'timeFrame': '12 months', 'description': 'Decision time was defined as the time from patient registration to decision for disposition.'}, {'measure': 'the percentage of LOS over 24 hours in all ED patients.', 'timeFrame': '12 months', 'description': 'The percentage was defined as patients staying at the ED over 24 hours/total ED visits.'}]}, 'oversightModule': {'oversightHasDmc': True, 'isFdaRegulatedDrug': False, 'isFdaRegulatedDevice': False}, 'conditionsModule': {'conditions': ['Length of Stay']}, 'descriptionModule': {'briefSummary': 'Emergency department (ED) crowding has become an international challenge in the recent decades.\n\nLength of stay (LOS) is a useful marker to monitor ED crowding. Searching for the possible causes and reducing barriers may have the greatest impact on EDLOS.\n\nTherefore, the investigators assembled a multidisciplinary team for improvement of the ED process, to undergo assessments of ED patient flow with the spirit of lean-sigma methodologies. The objectives of this study were to evaluate a Lean-sigma-based initiative to lessen EDLOS.', 'detailedDescription': 'Lean aims to smooth out the workflow and to eliminate wastes. In the ED settings, lean principles can display the process of the ED patient flow. Six sigma, a complementary strategy, has the merit to compensate the potential weakness of Lean through a data-driven process. Currently, a combination of Lean and Six sigma methodologies develops to solve the problems of workflow.\n\nIt became clear that concurrent multifaceted interventions were needed to reduce EDLOS. Therefore, the investigators assembled a multidisciplinary quality improvement team for improvement of the ED process, to undergo assessments of ED patient flow with the spirit of lean-sigma methodologies. The objectives of this study were to evaluate a Lean-sigma-based initiative to lessen EDLOS.'}, 'eligibilityModule': {'sex': 'ALL', 'stdAges': ['CHILD', 'ADULT', 'OLDER_ADULT'], 'samplingMethod': 'NON_PROBABILITY_SAMPLE', 'studyPopulation': 'The patients were registered in the ED of the Hsin-Chu branch from Jan, 2015 to Dec, 2015.', 'healthyVolunteers': False, 'eligibilityCriteria': 'Inclusion Criteria:\n\n* the patients were registered in the ED from Jan, 2015 to Dec, 2015.\n\nExclusion Criteria:\n\n* the patients were excluded because of left without seeing a physician.'}, 'identificationModule': {'nctId': 'NCT03185533', 'briefTitle': 'Reducing Length of Stay in the Emergency Department', 'organization': {'class': 'OTHER', 'fullName': 'National Taiwan University Hospital Hsin-Chu Branch'}, 'officialTitle': 'Reducing Length of Stay in the Emergency Department: Analyzing the Factors and Quality Improvement Interventions', 'orgStudyIdInfo': {'id': '105-061-E'}}, 'armsInterventionsModule': {'armGroups': [{'label': 'to reduce ED length of stay', 'description': 'to reduce ED length of stay to lessen ED crowding by using Lean-sigma management and quality improvement interventions including reducing boarding time and medical decision time.', 'interventionNames': ['Behavioral: Quality improvement (QI) interventions']}], 'interventions': [{'name': 'Quality improvement (QI) interventions', 'type': 'BEHAVIORAL', 'description': '1\\. The ED admissions exhibited prolonged length of stay.\n\n2\\. The Interventions for Reducing Medical Decision Time:\n\n1. The ED director created QI education sessions and reported monthly QI outcomes.\n2. The ED nurses reported the current number of ED admission patients twice a day to the director. The director summarized the bed requests to the administrative personnel.\n3. The nurses reported the in-scene complicated cases to the ED director. The director would give an assistance in managing these cases.\n\n3\\. The Interventions for Reducing Boarding Time\n\n1. The ED patients could be admitted before 8 a.m. if the bed was vacant.\n2. The ED director initiated an on-line meeting at 8 a.m. and 4 p.m.\n3. Monthly QI outcomes were reported in the hospital affairs meeting.', 'armGroupLabels': ['to reduce ED length of stay']}]}, 'ipdSharingStatementModule': {'ipdSharing': 'YES'}, 'sponsorCollaboratorsModule': {'leadSponsor': {'name': 'National Taiwan University Hospital Hsin-Chu Branch', 'class': 'OTHER'}, 'responsibleParty': {'type': 'PRINCIPAL_INVESTIGATOR', 'investigatorTitle': 'Director, Department of Emergency Medicine, NTUH Hsin-Chu branch', 'investigatorFullName': 'Wan-Ching Lien', 'investigatorAffiliation': 'National Taiwan University Hospital Hsin-Chu Branch'}}}}