The Emergency nurse Protocols Initiating Care-Sydney Triage to Admission Risk Tool (EPIC-START) trial: protocol for a stepped wedge implementation trial.

Curtis, K; Dinh, MM; Shetty, A; Kourouche, S; Fry, M; Considine, J; Li, L; Lung, T; Shaw, T; Lam, MK; Murphy, M; Alkhouri, H; Aggar, C; Russell, SB; Seimon, RV; Hughes, JA; Varndell, W; Shaban, RZ

The Emergency nurse Protocols Initiating Care-Sydney Triage to Admission Risk Tool (EPIC-START) trial: protocol for a stepped wedge implementation trial.

Curtis, K Dinh, MM Shetty, A Kourouche, S Fry, M

Considine, J Li, L Lung, T Shaw, T Lam, MK Murphy, M Alkhouri, H Aggar, C Russell, SB Seimon, RV Hughes, JA Varndell, W

Shaban, RZ

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Publisher:: Springer Nature
Publication Type:: Journal Article
Citation:: Implement Sci Commun, 2023, 4, (1), pp. 70
Issue Date:: 2023-06-20

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Field	Value	Language
dc.contributor.author	Curtis, K
dc.contributor.author	Dinh, MM
dc.contributor.author	Shetty, A
dc.contributor.author	Kourouche, S
dc.contributor.author	Fry, M https://orcid.org/0000-0003-1265-7096
dc.contributor.author	Considine, J
dc.contributor.author	Li, L
dc.contributor.author	Lung, T
dc.contributor.author	Shaw, T
dc.contributor.author	Lam, MK
dc.contributor.author	Murphy, M
dc.contributor.author	Alkhouri, H
dc.contributor.author	Aggar, C
dc.contributor.author	Russell, SB
dc.contributor.author	Seimon, RV
dc.contributor.author	Hughes, JA
dc.contributor.author	Varndell, W https://orcid.org/0000-0002-4752-9679
dc.contributor.author	Shaban, RZ
dc.date.accessioned	2023-11-05T23:55:42Z
dc.date.available	2023-06-04
dc.date.available	2023-11-05T23:55:42Z
dc.date.issued	2023-06-20
dc.identifier.citation	Implement Sci Commun, 2023, 4, (1), pp. 70
dc.identifier.issn	2662-2211
dc.identifier.issn	2662-2211
dc.identifier.uri	http://hdl.handle.net/10453/173004
dc.description.abstract	INTRODUCTION: Emergency department (ED) overcrowding is a global problem and a threat to the quality and safety of emergency care. Providing timely and safe emergency care therein is challenging. To address this in New South Wales (NSW), Australia, the Emergency nurse Protocol Initiating Care-Sydney Triage to Admission Risk Tool (EPIC-START) was developed. EPIC-START is a model of care incorporating EPIC protocols, the START patient admission prediction tool, and a clinical deterioration tool to support ED flow, timely care, and patient safety. The aim of this study is to evaluate the impact of EPIC-START implementation across 30 EDs on patient, implementation, and health service outcomes. METHODS AND ANALYSIS: This study protocol adopts an effectiveness-implementation hybrid design (Med Care 50: 217-226, 2012) and uses a stepped-wedge cluster randomised control trial of EPIC-START, including uptake and sustainability, within 30 EDs across four NSW local health districts spanning rural, regional, and metropolitan settings. Each cluster will be randomised independently of the research team to 1 of 4 dates until all EDs have been exposed to the intervention. Quantitative and qualitative evaluations will be conducted on data from medical records and routinely collected data, and patient, nursing, and medical staff pre- and post-surveys. ETHICS AND DISSEMINATION: Ethical approval for the research was received from the Sydney Local Health District Research Ethics Committee (Reference Number 2022/ETH01940) on 14 December 2022. TRIAL REGISTRATION: Australian and New Zealand Clinical trial, ACTRN12622001480774p. Registered on 27 October 2022.
dc.format	Electronic
dc.language	eng
dc.publisher	Springer Nature
dc.relation.ispartof	Implement Sci Commun
dc.relation.isbasedon	10.1186/s43058-023-00452-0
dc.rights	info:eu-repo/semantics/openAccess
dc.subject.classification	4203 Health services and systems
dc.subject.classification	4206 Public health
dc.title	The Emergency nurse Protocols Initiating Care-Sydney Triage to Admission Risk Tool (EPIC-START) trial: protocol for a stepped wedge implementation trial.
dc.type	Journal Article
utslib.citation.volume	4
utslib.location.activity	England
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
utslib.copyright.status	open_access	*
dc.date.updated	2023-11-05T23:55:40Z
pubs.issue	1
pubs.publication-status	Published online
pubs.volume	4
utslib.citation.issue	1

Abstract:

INTRODUCTION: Emergency department (ED) overcrowding is a global problem and a threat to the quality and safety of emergency care. Providing timely and safe emergency care therein is challenging. To address this in New South Wales (NSW), Australia, the Emergency nurse Protocol Initiating Care-Sydney Triage to Admission Risk Tool (EPIC-START) was developed. EPIC-START is a model of care incorporating EPIC protocols, the START patient admission prediction tool, and a clinical deterioration tool to support ED flow, timely care, and patient safety. The aim of this study is to evaluate the impact of EPIC-START implementation across 30 EDs on patient, implementation, and health service outcomes. METHODS AND ANALYSIS: This study protocol adopts an effectiveness-implementation hybrid design (Med Care 50: 217-226, 2012) and uses a stepped-wedge cluster randomised control trial of EPIC-START, including uptake and sustainability, within 30 EDs across four NSW local health districts spanning rural, regional, and metropolitan settings. Each cluster will be randomised independently of the research team to 1 of 4 dates until all EDs have been exposed to the intervention. Quantitative and qualitative evaluations will be conducted on data from medical records and routinely collected data, and patient, nursing, and medical staff pre- and post-surveys. ETHICS AND DISSEMINATION: Ethical approval for the research was received from the Sydney Local Health District Research Ethics Committee (Reference Number 2022/ETH01940) on 14 December 2022. TRIAL REGISTRATION: Australian and New Zealand Clinical trial, ACTRN12622001480774p. Registered on 27 October 2022.

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http://hdl.handle.net/10453/173004