Emergency Departments (EDs) across Ontario are being inundated with unprecedented high patient volumes and a staffing shortage that directly impacts patient care and flow. An area of concern among EDs is the offload zone where patients are brought in by ambulance. EMS offload time is the time it takes paramedics to transfer a patient to the appropriate area within an emergency department and give hospital staff a summary of what concerns the patient is seeking care for. There are multiple factors that may delay this time, including limited staff in the offload area to complete the transfer process due to competing patient care responsibilities. The adaptive staffing model study will look to add a primary care paramedic (PCP) or a registered nurse (RN) in the offload zone during times of high ambulance volume (August to January) to help with patient care within the offload zone. This single-centered community hospital study will evaluate the benefits of having a PCP or RN, compared to the current model, on ambulance offload times, patient safety outcomes, patient treatment times, and staff well-being using three different models of staffing.
Study Type
OBSERVATIONAL
Enrollment
5,917
Staffing the hospitals emergency department offload zone with a PCP or RN or current workflow.
Markham Stouffville Hospital
Markham, Ontario, Canada
RECRUITINGTriage Time
The aim of this objective is to compare time to triage and time to transfer of care for three models of staffing.
Time frame: 6 months
Return to Service
The aim of this objective is to determine if an adaptive staffing model during peak volumes reduces ambulance offload times and return to service.
Time frame: 6 months
Time to provider assessment
Time frame: 6 months
Provider Feedback Survey
Explore provider perceptions (ED staff and paramedics) of each model with the aim of determining which model provides better patient care during peak volumes. Participants will self-report their perceived barriers, challenges and benefits of the staffing interventions.
Time frame: 6 months
Time to treatment
Time frame: 6 months
Time to disposition
Time frame: 6 months
Number of incident reports
Patient safety events
Time frame: 6 months
Case costing
Time frame: 6 months
Well-being Index (questionnaire)
Explore staff and paramedic well-being on intervention model
Time frame: 6 months
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.