Evaluation of the Quality of Care in the Emergency Department by Studying the Appropriateness of Admissions of Patients Accessing the Emergency Department (Fondazione IRCCS Ca' Granda Ospedale Maggione Policlinico)

N/AActive Not RecruitingNCT06345352

Mario Negri Institute for Pharmacological Research1,200 enrolled

Overview

The aim of this study is to develop, study and validate a rigorous and sustainable method for assessing the clinical appropriateness of the decision taken in the Emergency Department to admit or not to admit patients.

The information normally recorded in the Emergency Department medical record will be used, as well as the available clinical and administrative databases. For reasons of feasibility, the investigators will also restrict the analysis to patients coming to the Emergency Department with non-specific manifestations in the pulmonary, cardiovascular and abdominal districts, represented by one or more of the following symptoms: dyspnoea, chest pain, transient loss of consciousness, abdominal pain.

Study Type

OBSERVATIONAL

Enrollment

1,200

Conditions

Quality of Care Evaluation Emergency Department Appropriateness

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adult patients * Presentation in the Emergency Department with non-specific cardiopulmonary or abdominal manifestations, represented by one or more of the following symptoms: chest pain, abdominal pain, dyspnoea, transient loss of consciousness. Exclusion Criteria: * Voluntary removal of the patient; * Sending home with instructions to return for further services

Outcomes

Primary Outcomes

Algorithm creation

To develop, for the types of patients taken into consideration, a classification algorithm of the appropriateness of admissions based on the files available at the Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (for simplicity: Policlinico hospital)

Time frame: September 2020 - January 2024

Algorithm validation

To validate the classification algorithm on a sample of hospital medical records.

Time frame: February 2024 - December 2024

Algorithm application

To apply the validated algorithm on patients referred to the PS of the Policlinico hospital over 36 months, to estimate the proportion of appropriate admissions.

Time frame: January 2025 - December 2027

Appropriateness estimation

Provide, for the types of patients considered, an estimate of appropriate discharges for patients discharged and subsequently admitted to the Polyclinic, by drawing on the data available at the polyclinic itself. For all other patients, data on living status and admissions to other facilities in the metropolitan area (PS administrative flow and hospital discharge cards - SDOs), will be analysed using data provided by the ATS Milano Città Metropolitana.