Evaluation of the Quality of Care in the Emergency Department by Studying the Appropriateness of Admissions of Patients Accessing the Emergency Department (Fondazione IRCCS Ca' Granda Ospedale Maggione Policlinico)

NCT06345352 — Active not recruiting, 1200 participants, Mario Negri Institute for Pharmacological Research

ClinicalTrials Daily · Areas · Conditions · Drugs · Sponsors ·

Evaluation of the Quality of Care in the Emergency Department by Studying the Appropriateness of the Admissions of Patients Accessing the PS: Construction and Validation of an Algorithm Based on Computerised Databases

Registry	NCT06345352
Status	Active not recruiting
Study type	Observational
Enrollment	1200 (Estimated)
Sponsor	Mario Negri Institute for Pharmacological Research (Other)
Conditions	Quality of Care, Evaluation, Emergency Department, Appropriateness
Dates	start 2020-09-15, primary completion 2026-12-01 (estimated), completion 2027-12-01 (estimated), first posted 2024-04-03, last updated 2026-05-20
Locations	1 site in Italy

-Summary

The aim of this study is to develop, study and validate a rigorous and sustainable method for assessing the clinical appropriateness of the decision taken in the Emergency Department to admit or not to admit patients.

Expand all sections · Collapse all

+Detailed description

The information normally recorded in the Emergency Department medical record will be used, as well as the available clinical and administrative databases. For reasons of feasibility, the investigators will also restrict the analysis to patients coming to the Emergency Department with non-specific manifestations in the pulmonary, cardiovascular and abdominal districts, represented by one or more of the following symptoms: dyspnoea, chest pain, transient loss of consciousness, abdominal pain.

+Arms and interventions

Arm	Type	Interventions	Description
Elegible population			All adult patients presenting to the emergency department with non-specific cardiopulmonary or abdominal manifestations, represented by one or more of the following symptoms: chest pain, abdominal pain, dyspnoea, transient loss of consciousness.

+Outcome measures

Primary outcomes

Algorithm creation [September 2020 - January 2024]: To develop, for the types of patients taken into consideration, a classification algorithm of the appropriateness of admissions based on the files available at the Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (for simplicity: Policlinico hospital)
Algorithm validation [February 2024 - December 2024]: To validate the classification algorithm on a sample of hospital medical records.
Algorithm application [January 2025 - December 2027]: To apply the validated algorithm on patients referred to the PS of the Policlinico hospital over 36 months, to estimate the proportion of appropriate admissions.
Appropriateness estimation [January 2025 - December 2027]: Provide, for the types of patients considered, an estimate of appropriate discharges for patients discharged and subsequently admitted to the Polyclinic, by drawing on the data available at the polyclinic itself. For all other patients, data on living status and admissions to other facilities in the metropolitan area (PS administrative flow and hospital discharge cards - SDOs), will be analysed using data provided by the ATS Milano Città Metropolitana.

+Eligibility

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Adult patients
* Presentation in the Emergency Department with non-specific cardiopulmonary or abdominal manifestations, represented by one or more of the following symptoms: chest pain, abdominal pain, dyspnoea, transient loss of consciousness.

Exclusion Criteria:

* Voluntary removal of the patient;
* Sending home with instructions to return for further services

+Locations (1)

Facility	City	Country	Status
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano	Milan, MI	Italy

My Notes

Public

To Read Reading Read