Implementation of the Individual Danish Emergency Process Triage (I-DEPT)

March 30, 2023 updated by: Kasper Iversen, Herlev Hospital

Implementation of the Individual Danish Emergency Process Triage (I-DEPT)

The purpose of the study is to implement and evaluate a novel triage algorithm for risk stratification of acutely admitted patients in the Emergency Department.

Study Overview

Status

Completed

Intervention / Treatment

Detailed Description

Triage algorithms are used worldwide to risk assess and prioritize patients in the Emergency Departments. The aim is to identify patient at risk of deterioration or death and/or with a imminent need of treatment. The triage algorithms are also developed to identify patients at low risk, who safely can be assigned to the waiting room.

Currently, several different triage algorithms are used, and they are mostly based on consensus and exper- opinion. Therefore evidence concerning triage is limited.

The investigators has developed a novel evidence-based triage algorithm with integrated individual clinical assesment. The vitals measured at admission assigns the patient to a triage category, and based upon the clinical appearance of the patients, the triage nurse can adjust the assigned triage category to better reflect the patient. The triage algorithm used in Denmark is "DEPT", this algorithm is based purely on vitals and cause of admission and can not be adjusted.

I-DEPT is designed as a cluster randomized stepped-wedge non-inferiority study. The Aim is to implement and compare I-DEPT to the existing triage algorithm. All Emergency Departments in the Capitol Region and the Region og Zealand in Denmark will implement I-DEPT one department at a time (8 centers). The first will start the implementation on october 1, 2020 and after two months the next center will implement I-DEPT. Every two months a new center will start. During 16 months all centers will have implemented I-DEPT the sequence of centers was determined by randomization. The first 30 days of implementation will be censored and not included in the final analyses. The study will conclude with a period of 30 days follow-up. Patients will only be included once.

Study Type

Interventional

Enrollment (Actual)

250000

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

      • Copenhagen, Denmark, 2200
        • Bispebjerg and Frederiksberg Hospital
      • Hillerød, Denmark, 3400
        • Nordsjællands Hospital
      • Holbæk, Denmark, 4300
        • Holbæk Hospital
      • Hvidovre, Denmark, 2650
        • Hvidovre, Amager and Glostrup Hospital
      • Køge, Denmark, 4600
        • Sjælland University hospital
      • Nykøbing Falster, Denmark, 4800
        • Nykøbing Falster Hospital
      • Slagelse, Denmark, 4200
        • Slagelse Hospital
    • Capital Region
      • Herlev, Capital Region, Denmark, 2730
        • Herlev and Gentofte Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

17 years to 110 years (Child, Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Admission to a participating Emergency Department in the study period
  • Full triage assesment in the index admission

Exclusion Criteria:

  • Age below 17 years
  • Death at arrival or before triage assesment

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Sequential Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: I-DEPT
Novel triage. The triage nurse can adjust the triage category one level of urgency down or one or two levels up.
Implementation of the novel triage algorithm
Active Comparator: DEPT
Existing triage algorithm
Existing triage algorithm

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
30-day mortality
Time Frame: 30 days
All cause mortality within 30 days following triage in the index admission by non-inferiority
30 days

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
2-day mortality
Time Frame: 2 days
All cause mortality within 2 days following triage in the index admission
2 days
Distribution of triage categories
Time Frame: 1 day
There are four categories in both triage algorithms used in this study: (green (least urgent), yellow, orange, and red (most urgent))
1 day
Patients in the orange triage category
Time Frame: 1 day
Number of patients assigned to the orange category
1 day
Doctor assessment
Time Frame: 1 day
Time from triage to arrival of a doctor
1 day
Days in hospital
Time Frame: 30 days
The number of days admitted to a hospital within 30 days
30 days
Time in the Emergency Department
Time Frame: 30 days
Time spent in the Emergency department from triage to either admission, transfer or discharge
30 days
Patients left without being seen
Time Frame: 30 days
Number of patients leaving the Emergency Department without being assessed by a doctor
30 days

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

October 1, 2020

Primary Completion (Actual)

May 1, 2022

Study Completion (Actual)

May 1, 2022

Study Registration Dates

First Submitted

September 24, 2020

First Submitted That Met QC Criteria

September 29, 2020

First Posted (Actual)

September 30, 2020

Study Record Updates

Last Update Posted (Actual)

April 3, 2023

Last Update Submitted That Met QC Criteria

March 30, 2023

Last Verified

March 1, 2023

More Information

Terms related to this study

Other Study ID Numbers

  • 568

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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