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CTRI Number  CTRI/2024/03/064319 [Registered on: 18/03/2024] Trial Registered Prospectively
Last Modified On: 17/03/2024
Post Graduate Thesis  No 
Type of Trial  Observational 
Type of Study   Prospective observational study 
Study Design  Single Arm Study 
Public Title of Study   Evaluation of factors causing delayed transfer from emergency departments 
Scientific Title of Study   Evaluation of Factors Causing Delayed Patient Transfer from Emergency Department to Specialized Units: A Prospective Observational Study. 
Trial Acronym   
Secondary IDs if Any  
Secondary ID  Identifier 
NIL  NIL 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Dr Pooja thaware 
Designation  Assistant Professor 
Affiliation  All India Institute of Medical Sciences, Bhopal 
Address  Department of Trauma and Ememrgency Medicine, AIIMSn Bhopal,Saket Nagar, habibganj, Bhopal

Bhopal
MADHYA PRADESH
462026
India 
Phone  6264382992  
Fax    
Email  pooja.tem@aiimsbhopal.edu.in  
 
Details of Contact Person
Scientific Query
 
Name  Dr Pooja thaware 
Designation  Assistant Professor 
Affiliation  All India Institute of Medical Sciences, Bhopal 
Address  Department of Trauma and Ememrgency Medicine, AIIMSn Bhopal,Saket Nagar, habibganj, Bhopal

Bhopal
MADHYA PRADESH
462026
India 
Phone  6264382992  
Fax    
Email  pooja.tem@aiimsbhopal.edu.in  
 
Details of Contact Person
Public Query
 
Name  Dr Pooja thaware 
Designation  Assistant Professor 
Affiliation  All India Institute of Medical Sciences, Bhopal 
Address  Department of Trauma and Ememrgency Medicine, AIIMSn Bhopal,Saket Nagar, habibganj, Bhopal

Bhopal
MADHYA PRADESH
462026
India 
Phone  6264382992  
Fax    
Email  pooja.tem@aiimsbhopal.edu.in  
 
Source of Monetary or Material Support  
All India Institute of medical Sciences, Bhopal, Pin:462020 
 
Primary Sponsor  
Name  NOT APPLICABLE observational study 
Address  NA 
Type of Sponsor  Other [] 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr pooja Thaware  All India Institute of Medical Sciences, Bhopal  Deartment of trauma and Emegency medicine, AIIMS Bhopal, saket nagar, habibganj, bhopal/Ground floor,Red, yellow and green triage zones including 2 critical units.
Bhopal
MADHYA PRADESH 
6264382992

pooja.tem@aiimsbhopal.edu.in 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
AIIMS Bhopal IHEC  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: Y939||Activity, unspecified,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Intervention  NIL  NIL 
 
Inclusion Criteria  
Age From  18.00 Year(s)
Age To  90.00 Year(s)
Gender  Both 
Details  Patients admitted in ED for more than 24 hours aged 18 years and above of either gender.  
 
ExclusionCriteria 
Details  pediatric and pregnant patients 
 
Method of Generating Random Sequence   Not Applicable 
Method of Concealment   Not Applicable 
Blinding/Masking   Not Applicable 
Primary Outcome  
Outcome  TimePoints 
1.To record and categorize the root causes of the delayed transfer.  24 and 48 hr 
 
Secondary Outcome  
Outcome  TimePoints 
1.To assess the impact of disease severity (APACHE II score) in decision making/ delay for ICU/ HDU/ ward transfer.  0,6,12,24 hrs 
 
Target Sample Size   Total Sample Size="450"
Sample Size from India="450" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   N/A 
Date of First Enrollment (India)   25/03/2024 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="0"
Months="6"
Days="0" 
Recruitment Status of Trial (Global)   Not Yet Recruiting 
Recruitment Status of Trial (India)  Not Yet Recruiting 
Publication Details   N/A 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - YES
  1. What data in particular will be shared?
    Response - Individual participant data that underlie the results reported in this article, after de-identification (text, tables, figures, and appendices).

  2. What additional supporting information will be shared?
    Response -  Study Protocol
    Response -  Statistical Analysis Plan
    Response - Informed Consent Form

  3. Who will be able to view these files?
    Response - Researchers whose proposed use of the data has been approved by an independent review committee identified for this purpose.

  4. For what types of analyses will this data be available?
    Response - For individual participant data meta-analysis.

  5. By what mechanism will data be made available?
    Response - Proposals should be directed to [pooja.tem@aiimsbhopal.edu.in].

  6. For how long will this data be available start date provided 07-03-2025 and end date provided 07-08-2024?
    Response - Immediately following publication. No end date.

  7. Any URL or additional information regarding plan/policy for sharing IPD? 
    Additional Information - Nil
Brief Summary  

The efficient transfer of patients from the emergency department (ED) to specialized departments is a critical component of healthcare delivery. Timely transfers are essential to ensure patients receive the appropriate care they need promptly. Delivering patient transfers can lead to adverse outcomes and extended hospital stays. This study investigates the various causes of delayed patient transfers and their impact on patient care.

The proposed study aims to serve as a quality improvement project within our institute, investigating the factors contributing to delayed transfers in all specialized departments, including the ICU. Unlike a previous study that concentrated solely on ICU admission from the emergency department, primarily examining the mortality difference between patients transferred within 30 minutes of decision-making and those with delayed transfer, our study introduces a novel perspective by centralizing its primary objective on delineating the administrative and non-administrative reasons for not escalating care from the Emergency Department (ED) to all specialized departments.

The motivation for undertaking this research lies in the acknowledgment that the causes of delayed transfer may vary within our institute compared to the findings reported by previous studies, such as the one conducted by Bosco et al.[5] The shift in focus to encompass all specialized departments allows for a more comprehensive understanding of the challenges associated with patient transfers beyond the ICU. By undertaking a prospective observational study, we aim to identify and analyze the multifaceted factors contributing to delayed transfers, thereby providing valuable insights that can inform targeted interventions for improvement.

The study’s rationale stems from the recognition that timely patient transfers are critical for optimizing patient outcomes and enhancing the overall quality of care. By scrutinizing both administrative and non-administrative aspects influencing the transfer process, we aspire to contribute to the development of evidence-based strategies that address the unique dynamics within our institute. This research not only fills a gap in the existing literature, which predominantly focuses on outcomes rather than causative factors but also aligns with our commitment to continuous quality improvement in patient care.

The prospective nature of the study allows for real-time data collection and analysis, enabling us to capture the dynamic and evolving nature of patient transfers. Collaborative engagement with healthcare professionals across specialized departments will be emphasized, ensuring a holistic understanding of the challenges and facilitating the identification of tailored solutions. Ultimately, the dissemination of the study findings is envisaged to not only benefit our institute but also contribute to the broader healthcare community by offering valuable insights and best practices for optimizing the patient transfer process.

 Ensuring timely transfers of patients is vital to ensure proper care and prevent negative consequences like increased morbidity, prolonged hospital stays, and operational challenges. This study is crucial for several reasons: it aids in quality improvement by identifying the root causes of delays, allowing for strategies to enhance care quality. It also supports efficient resource allocation, which can optimize operations. Prioritizing timely patient transfers aligns with patient-centered care principles, focusing on patient needs. Moreover, addressing delays can lead to cost reduction by minimizing unnecessary expenses associated with extended hospital stays and complications. Lastly, the study provides data-driven insights for informed decision-making and policy development within the healthcare facility.

 
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