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The Emergency nurse Protocols Initiating Care-Sydney Triage to Admission Risk Tool (EPIC-START) trial: protocol for a
Kate Curtis1,2, Michael M Dinh3,4,5, Amith Shetty6,7
1Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Camperdown, NSW, Australia. kate.curtis@sydney.edu.au.
Implementation Science Communications
|June 20, 2023
Summary
Emergency department overcrowding is a global challenge. The Emergency nurse Protocol Initiating Care-Sydney Triage to Admission Risk Tool (EPIC-START) was evaluated in 30 EDs to improve patient care and safety.
Area of Science:
- Emergency medicine
- Healthcare management
- Implementation science
Background:
- Emergency department (ED) overcrowding poses a significant threat to patient safety and care quality globally.
- Timely and safe emergency care delivery is a persistent challenge in overcrowded EDs.
- The Emergency nurse Protocol Initiating Care-Sydney Triage to Admission Risk Tool (EPIC-START) was developed in New South Wales (NSW), Australia, to address these issues.
Purpose of the Study:
- To evaluate the impact of the EPIC-START model of care on patient, implementation, and health service outcomes.
- To assess the effectiveness of EPIC-START in supporting ED flow, timely care, and patient safety.
- To determine the uptake and sustainability of EPIC-START across diverse healthcare settings.
Main Methods:
- An effectiveness-implementation hybrid design utilizing a stepped-wedge cluster randomized controlled trial.
- Implementation across 30 EDs in rural, regional, and metropolitan NSW local health districts.
- Quantitative and qualitative data collection from medical records, routinely collected data, and pre- and post-surveys of patients and staff.
Main Results:
- Data analysis is ongoing.
- Results will inform the broader applicability of EPIC-START.
- Findings will guide future strategies for improving ED patient flow and safety.
Conclusions:
- The study aims to provide evidence on the effectiveness of EPIC-START in improving ED operations.
- Findings will contribute to understanding successful implementation strategies for healthcare interventions.
- The research is expected to inform policy and practice for managing ED overcrowding.
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