The Effect of Telehealth Ontario on Non-Urgent Emergency Department Use at The Hospital for Sick Children - Full Text View

Sponsored by:	The Hospital for Sick Children
Information provided by:	The Hospital for Sick Children
ClinicalTrials.gov Identifier:	NCT00625027

Purpose

The purpose of this study is to compare the rate of non-urgent emergency department use between three groups of patients: those who were referred to the emergency department by Telehealth Ontario; those who were referred by a physician; and those who arrived without being advised by a nurse or a doctor.

Condition	Intervention
Emergency Department Visit	Other: Survey and Chart Review

Study Type:	Observational
Study Design:	Case-Only, Prospective
Official Title:	The Effect of Telehealth Ontario on Non-Urgent Emergency Department Use at The Hospital for Sick Children

Further study details as provided by The Hospital for Sick Children:

Primary Outcome Measures:

The triage categories among patients who did or did not have contact with a health care professional prior to arrival in the ED. [ Time Frame: At time of visit to the ED ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

The demographic and other details of patients arriving with urgent compared to non- urgent complaints. [ Time Frame: At time of visit to the ED ] [ Designated as safety issue: No ]

Biospecimen Retention: None Retained

Biospecimen Description:

Enrollment:	115
Study Start Date:	March 2004
Study Completion Date:	September 2006
Primary Completion Date:	September 2006 (Final data collection date for primary outcome measure)

Groups/Cohorts	Assigned Interventions
Group 1 Children presenting to the Emergency Department under the care of a parent or guardian, between 0600 and 2400 during the study period.	Other: Survey and Chart Review After obtaining consent the survey will be completed. After a staff physician has assessed the patient, the chart will be consulted to retrieve the triage notes, diagnosis, treatment, and discharge recommendations. The physician will be asked to comment on the 'urgency' of the complaint and whether the patient would have been treated equally well at a walk-in clinic.

Groups/Cohorts

Assigned Interventions

Group 1

Children presenting to the Emergency Department under the care of a parent or guardian, between 0600 and 2400 during the study period.

Other: Survey and Chart Review

After obtaining consent the survey will be completed. After a staff physician has assessed the patient, the chart will be consulted to retrieve the triage notes, diagnosis, treatment, and discharge recommendations. The physician will be asked to comment on the 'urgency' of the complaint and whether the patient would have been treated equally well at a walk-in clinic.

Detailed Description:

Some studies have shown that certain telephone nursing advice lines are effective in reducing non-urgent emergency department use. However, to my knowledge, no study has investigated the efficacy of Telehealth Ontario in particular. There are important differences between Telehealth Ontario and other phone lines that have been evaluated, in terms of the method in which calls are handled, the diversity of the population served, and the place of the phone-in line within the health care system. These studies, the results of which cannot be extrapolated directly to Telehealth Ontario, should not replace the direct study of the impact and utility of Telehealth Ontario.

Currently Telehealth Ontario receives over 3000 calls daily from residents of Ontario who are concerned about their health. These callers rely on the advise of Telehealth nurses to direct the care they seek out for themselves and for their families. The provincial government also relies on Telehealth Ontario - to provide a useful service within the health care system, relieving the pressure on over-crowded emergency departments by directing patients with non-urgent medical complaints to more appropriate avenues of treatment. This will be the first study to examine the impact of Telehealth Ontario. Although only a small aspect of Telehealth's impact will be examined - the impact on non-urgent emergency department use at Sick Kids - it is an important first step. The results of this study may serve to guide modifications to Telehealth that will make it more accessible to specific groups within the community, more reliable in the advice it provides, and more effective in delivering its message to callers.

Eligibility

Ages Eligible for Study:	up to 18 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No
Sampling Method:	Probability Sample

Study Population

All children presenting to the ED between 0600 and 2400 during the study period

Criteria

Inclusion Criteria:

All children presenting to the ED between 0600 and 2400 during the study period

Exclusion Criteria:

Children arriving without an adult, as consent could not be obtained.
Children with whose parents communication was not possible in English, as it was not possible to provide translation services for this study.
Children arriving by direct transfer from another hospital.
Children arriving by ambulance summoned by someone other than the parent or guardian.
Children arriving at the ED for a pre-arranged visit/appointment.
Children requiring immediate resuscitation.

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00625027

Locations

Canada, Ontario
The Hospital for Sick Children
Toronto, Ontario, Canada, M5G 1X8

Sponsors and Collaborators

The Hospital for Sick Children

Investigators

Study Chair:

Dennis Scolnik, MB ChB

The Hospital for Sick Children

More Information

No publications provided

Responsible Party:	The Hospital for Sick Children ( Dennis Scolnik/Principal Investigator )
Study ID Numbers:	1000004841
Study First Received:	February 19, 2008
Last Updated:	May 22, 2008
ClinicalTrials.gov Identifier:	NCT00625027 History of Changes
Health Authority:	Canada: Ethics Review Committee

Keywords provided by The Hospital for Sick Children:

Emergency Department Visit
Telehealth Ontario
Triage Levels

Study placed in the following topic categories:

Emergencies

Additional relevant MeSH terms:

Disease Attributes
Pathologic Processes
Emergencies

ClinicalTrials.gov processed this record on September 04, 2009