Establishment of Emergency Surgery Triage and Checklist Management System

Establishment of Emergency Surgery Triage and Checklist Management System--A Mixed Method Study

The goal of this observational study is to develop and test a system for managing emergency surgery patients at Beijing Union Medical College Hospital. The main questions it aims to answer are:

What information is necessary for effective patient triage and handovers between the emergency department, anesthesia, and ICU for surgical patients? How effective and feasible is a standardized handover process in improving patient outcomes and safety?

Participants will:

Be observed and have their handovers documented to identify key information required.

Participate in implementing a new handover checklist and triage system.

Researchers will compare the periods before and after implementing the new system to see if it:

Reduces missed critical information during handovers. Decreases pre-surgery waiting times for critically ill patients. Improves overall patient safety and outcomes, including reducing postoperative complications, mortality rates, length of hospital stay, and medical costs.

Study Overview

• Status: Active, not recruiting
• Conditions: Perioperative/Postoperative Complications; Triage; Emergency Surgery; Checklist

Detailed Description

The study will be conducted in several phases to establish a comprehensive emergency surgery triage and checklist management system at Beijing Union Medical College Hospital.

Phase 1: Literature Review and Initial Assessment First, a comprehensive review of existing literature and past emergency surgery cases will be conducted to identify common issues and best practices.

Phase 2: Expert Panel and Delphi Process An expert panel consisting of hospital management staff, anesthesiologists, emergency surgeons, ICU intensivists, and ER doctors will be formed. This panel will engage in a Delphi process to discuss and develop a standardized system for managing emergency surgery patients.

Phase 3: System Implementation and Testing

The newly developed system will be implemented and tested. Key metrics to be documented, evaluated, and compared include:

The number of omitted information items during the emergency-anesthesia handover.

Staff satisfaction with the new handover process across the emergency department, general surgery, anesthesia, and ICU.

In-hospital mortality rate after surgery. Postoperative in-hospital complications, classified by Clavien-Dindo grading, and their incidence rate.

Patient waiting times, including time to theatre and time to incision. Duration of the handover process. Incidence of follow-up calls to inquire about additional information after the handover.

Phase 4: Evaluation and Comparison The effectiveness and feasibility of the new system will be evaluated by comparing the collected data before and after its implementation. This comparison will help determine the system's impact on improving patient outcomes, safety, and staff efficiency.

By systematically addressing the critical points of patient handovers and emergency surgery management, this study aims to enhance overall healthcare quality and patient safety in emergency surgical settings.

• Study Type: Observational
• Enrollment (Estimated): 60

Contacts and Locations

Study Locations

• China
  • Beijing
    • Beijing, Beijing, China, 100730
      • Peking Union Medical College Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

Patients scheduled for emergency surgery at Peking Union Medical College Hospital

Description

Inclusion Criteria:

• Patients scheduled for emergency surgery.
• Patients whose condition is critical before surgery, requiring admission to the resuscitation room, emergency observation, or other hospital wards for treatment.

Exclusion Criteria:

• None

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
after implementation; Patients undergoing emergency surgery at Peking Union Medical College Hospital after Emergency Surgery Triage and Checklist Management System

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The number of omitted information	The number of omitted information items during the emergency-anesthesia handover.	Outcome will be assessed on the operative day

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Patient waiting times, including time to theatre and time to incision.	Time to Theatre (TTT): This is defined as the duration from when it is determined that the patient needs surgery to the time the patient arrives at the operating theatre. Time to Knife (TTK): This is defined as the duration from when the patient enters the operating theatre to the time the first incision is made.	Outcome will be assessed on the operative day
Feasibility of handover checklist	Staff satisfaction with the new handover process across the emergency department, general surgery, anesthesia, and ICU. Whether the handover checklist is considered necessary will and feasible will be assessed using a 5 point Likert scale.	Outcome will be assessed on the operative day
In-hospital mortality	In-hospital mortality	From date of admission until discharge, assessed up to 4 weeks
In-hospital morbidity	In-hospital morbidity will be documented and rated using Clavein-Dindo classification system	From date of admission until discharge, assessed up to 4 weeks

Collaborators and Investigators

• Sponsor: Peking Union Medical College Hospital

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2024
• Primary Completion (Estimated): September 1, 2025
• Study Completion (Estimated): December 1, 2025

Study Registration Dates

• First Submitted: June 12, 2024
• First Submitted That Met QC Criteria: July 8, 2024
• First Posted (Actual): July 15, 2024

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: March 4, 2025
• Last Verified: March 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Emergencies; Postoperative Complications
• Other Study ID Numbers: I-24PJ1128

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
• product manufactured in and exported from the U.S.: No