Evaluation of a rapid assessment and treatment app designed for nurses
Research type
Research Study
Full title
Evaluation of SortED tablet- an application being developed for Emergency Department nurses to provide comprehensive initial assessment of an undifferentiated patient population presenting to a London Emergency Department
IRAS ID
281049
Contact name
Barbara cleaver
Contact email
Sponsor organisation
Imperial College London
Duration of Study in the UK
1 years, 1 months, 27 days
Research summary
Imperial College Healthcare NHS trust's Emergency Departments (ED) are reporting versus new NHS England performance targets/indicators. One is time from arrival to initial clinical assessment (target <15 minutes). The other is mean length of stay (LOS) for patients in the ED (ED-LOS).
Evidence for the need for this project suggests that Imperial would have difficulty meeting the first target and that ED-LOS is poor. Charing Cross Hospital (CXH) have decided to reorganise their system: moving away from triage in ED (or GP-streaming in the Urgent Care Centre - UCC), to a unified process led by Advanced Care Practitioners (ACPs). We believe that a similar process to doctor-led RAT (rapid assessment and treatment) is needed. The SortED tablet app is designed to assist ACPs to shift the timing of these two key events: (1) the point at which investigations are ordered and (2) the point at which treatments are first identified. Currently there is a 2-3 step ED system where a nurse performs a brief triage, just setting the acuity. Patients then wait (a median 40 minutes after triage) for a doctor or nurse-clinician to order investigations. They may then wait again before treatments are prescribed (median 80 minutes post-arrival).
By providing ACPs with shortlists of relevant investigations this long wait between triage and investigation should be eliminated. Since study nurses are not ACP's the attending consultant will supervise investigation orders. The early identification of which treatments will be needed often has bearing on where the patient is best seen and is therefore relevant to optimal streaming in UCCs.
Two trials will take place each processing at least 500 patients, testing the unified approach. An ED 'front door' study replacing the two steps (nurse-triage then clinician-led investigation), and a UCC study (replacing GP streaming then later investigation by GP or nurse-practitioner).
REC name
London - Surrey Borders Research Ethics Committee
REC reference
22/PR/1049
Date of REC Opinion
24 Aug 2022
REC opinion
Further Information Favourable Opinion