Impact of a Mediator for Patient Intake in Emergency Departments (MEDIA)

Welcoming Patients in Emergency Departments: Impact of the Mediator

Violence in the workplace is becoming a serious phenomenon in the contemporary world of work. Hospital staff, like any employee working in contact with the public, is particularly exposed to this violence. In emergency departments, the number of patients treated and their heterogeneity, the problems of communicating with healthcare professionals, and waiting times, favor conflict situations. In the already tense context of the emergencies, the incivilities or violent acts have an impact on the well-being of professionals. In order to prevent these situations of violence, a solution could be to integrate a professional with specific skills into the teams to perform mediation functions between caregivers and patients.

The aim of the study is to evaluate the impact of the presence of a mediator in emergency services on personal (verbal or physical) attacks on professionals (caregivers, doctors, administrative staff).

Study Overview

• Status: Completed
• Conditions: Violent Aggressive Behavior; Mediation
• Intervention / Treatment: Behavioral: Presence of a mediator in the emergency departments

• Study Type: Observational
• Enrollment (Actual): 2378

Contacts and Locations

Study Locations

• France
  • Lyon, France, 69003
    • Pôle Information Médicale, Evaluation, Recherche - Hospices Civils de Lyon
  • Lyon, France, 69003
    • Service d'urgences médicales et chirurgicales - Hôpital Edouard Herriot - HCL
  • Lyon, France, 69004
    • Service médical d'accueil des urgences - Hôpital de la Croix Rousse - HCL
  • Pierre-Bénite, France
    • Service d'accueil des urgences - Centre hospitalier Lyon Sud - HCL

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

The population participating in the study is composed of:

• patients admitted to the emergency department,
• persons accompanying patients,
• professionals of the emergency departments (nurses, MD, administrative staff).

Description

Inclusion Criteria:

• Patient aged 18 years or older.
• Registered at the reception of the emergency department between 8 am and 8 pm, excluding bank holidays.

Exclusion Criteria:

• Patient with psychiatric disorders or impairment of judgment related to the taking of toxic substances.
• Patients requiring medical care in less than 30 minutes (sort code).

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Control; Patients treated in emergency departments without the presence of a mediator.
Mediation; Patients treated in emergency departments with the presence of a mediator.	Behavioral: Presence of a mediator in the emergency departments; The mediator tasks are : Be available to patients who can solicit him and respond to their requests for information, in particular on the organization of the emergency departments and on waiting times; Have a proactive attitude towards patients showing nervousness signs; Report patients expressing the will to leave the emergency departments before medical care; Manage conflicts between patients / accompanying persons and emergency staff and also between patients.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Incidence of violence or aggression by patients directed towards emergency staff	The violence or aggression will be collected by professionals of the emergency department. They will be classified in 4 levels of gravity.	During the patient stay in the emergency department, an average of 3 hours, up to 8 hours.
Incidence of violence or aggression by patients's accompanying persons directed towards emergency staff	The violence or aggression will be collected by professionals of the emergency department. They will be classified in 4 levels of gravity.	During the patient stay in the emergency department, an average of 3 hours, up to 8 hours.

Collaborators and Investigators

• Sponsor: Hospices Civils de Lyon

Publications and helpful links

General Publications

• Charrier P, Occelli P, Buchet-Poyau K, Douplat M, Delaroche-Gaudin M, Fayard-Gonon F, Jacquin L, Potinet V, Sigal A, Tazarourte K, Touzet S. Strategies used by emergency care professionals to handle interpersonal difficulties with patients: a qualitative study. BMJ Open. 2021 Feb 8;11(2):e042362. doi: 10.1136/bmjopen-2020-042362.

Study record dates

Study Major Dates

• Study Start (Actual): November 15, 2017
• Primary Completion (Actual): June 1, 2019
• Study Completion (Actual): June 1, 2019

Study Registration Dates

• First Submitted: April 28, 2017
• First Submitted That Met QC Criteria: May 2, 2017
• First Posted (Actual): May 3, 2017

Study Record Updates

• Last Update Posted (Actual): December 16, 2019
• Last Update Submitted That Met QC Criteria: December 12, 2019
• Last Verified: December 1, 2019

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavioral Symptoms; Pathologic Processes; Disease Attributes; Aggression; Emergencies
• Other Study ID Numbers: 69HCL17_0038

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No