ICU Triage Practices in a Cancer Hospital

Sponsor

M.D. Anderson Cancer Center (Other)

Overall Status

Completed

CT.gov ID

NCT03401411

Collaborator

(none)

257

Enrollment

Locations

Arms

39.1

Actual Duration (Months)

85.7

Patients Per Site

2.2

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

The primary objective of this study is aimed at analyzing the ICU triage practices of clinicians at a cancer hospital with and without the use of an algorithm-based triage tool, and to assess whether or not the triage tool improves the consensus amongst practioners on the prioritization of patients for ICU admission. Secondary objectives include assessment of whether or not triage practices based on guidelines correlate with what is done in actual practice.

Condition or Disease	Intervention/Treatment	Phase
Intensive Care Units Triage	Behavioral: Survey Behavioral: Algorithm-based Triage Tool	N/A

Detailed Description

This is a prospective study designed to evaluate the ICU triage practices of clinicians at MD Anderson Cancer Center using the standard Society of Critical Care Medicine Prioritization Model (SCCMP) versus a uniquely designed flowchart-based triage tool created specifically for the oncologic setting.

Study participants will initially receive either an email explaining the study and asking if they would agree to participate in the survey, or a hard copy of an identical letter. Their participation will remain anonymous, and will strictly be on a volunteer basis. If the participant wishes to participate, they will be given either a link to the survey using an institutionally improved electronic survey tool, or alternatively a hard copy of the survey with identical instructions.

The survey consists of 15 fictional patient case scenarios, and participants will be asked to use the modified SCCMP to prioritize each patient scenario into one of the 5-point likert-scale categories for admission. The participants will be randomized with 1:1 ratio to use either a) the standard SCCMP or b) the SCCMP in addition to a newly designed flowchart-based triage guide to prioritize each patient case scenario into one of the 5-point likert-scale categories.

Study Design

Study Type:

Interventional

Actual Enrollment :

257 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Masking:

Double (Participant, Investigator)

Primary Purpose:

Other

Official Title:

Intensive Care Unit (ICU) Triage Practices in a Cancer Hospital

Actual Study Start Date :

Nov 17, 2014

Actual Primary Completion Date :

Feb 20, 2018

Actual Study Completion Date :

Feb 20, 2018

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Standard SCCMP Health care provider completes triage survey of 15 fictional patient case scenarios using the standard SCCMP to prioritize each for admission.	Behavioral: Survey Survey of 15 fictional patient case scenarios to be assessed by participant using the standard prioritization or modified SCCMP to prioritize each patient scenario into one of a 5-point likert-scale categories for ICU admission. SCCMP scale categorized as 1-Critically ill to 4-Less likely to require ICU. Other Names: Society of Critical Care Medicine Prioritization Model
Experimental: SCCMP + Algorithm-based Triage Tool Health care provider completes triage survey of 15 fictional patient case scenarios using SCCMP in addition to a newly designed flowchart-based triage guide to prioritize each for admission.	Behavioral: Survey Survey of 15 fictional patient case scenarios to be assessed by participant using the standard prioritization or modified SCCMP to prioritize each patient scenario into one of a 5-point likert-scale categories for ICU admission. SCCMP scale categorized as 1-Critically ill to 4-Less likely to require ICU. Other Names: Society of Critical Care Medicine Prioritization Model Behavioral: Algorithm-based Triage Tool Newly designed flowchart-based triage guide to prioritize each patient case scenario into one of the 5-point likert-scale categories, used in conjunction with SCCMP for ICU admission.

Arm

Intervention/Treatment

Experimental: Standard SCCMP

Health care provider completes triage survey of 15 fictional patient case scenarios using the standard SCCMP to prioritize each for admission.

Behavioral: Survey

Survey of 15 fictional patient case scenarios to be assessed by participant using the standard prioritization or modified SCCMP to prioritize each patient scenario into one of a 5-point likert-scale categories for ICU admission. SCCMP scale categorized as 1-Critically ill to 4-Less likely to require ICU.

Other Names:

Society of Critical Care Medicine Prioritization Model

Experimental: SCCMP + Algorithm-based Triage Tool

Health care provider completes triage survey of 15 fictional patient case scenarios using SCCMP in addition to a newly designed flowchart-based triage guide to prioritize each for admission.

Behavioral: Survey

Other Names:

Society of Critical Care Medicine Prioritization Model

Behavioral: Algorithm-based Triage Tool

Newly designed flowchart-based triage guide to prioritize each patient case scenario into one of the 5-point likert-scale categories, used in conjunction with SCCMP for ICU admission.

Outcome Measures

Primary Outcome Measures

Agreement among clinicians for each of triage tools: SCCMP Standard versus SCCMP + Algorithm-based Triage Tool [20 minutes for participant survey completion]
Survey responses used to evaluate the ICU triage practices of clinicians using the standard SCCMP versus a uniquely designed flowchart-based triage tool created specifically for the oncologic setting. Participants are randomized to use either a) the standard SCCMP or b) the SCCMP in addition to a newly designed flowchart-based triage guide to prioritize 15 fictional patient case scenarios into one of the 5-point likert-scale categories for admission. SCCMP system defines those that will benefit most from the ICU (Priority 1) to those that will not benefit at all (Priority 4) from ICU admission. Reported proportion of clinicians choosing category i in the 5-point likert-scale, i=1, 2, 3, 4a or 4b, for a particular patient case. The range of the entropy is between 0 (perfect agreement among the clinicians) and 1.61 (total disagreement among the clinicians).

Eligibility Criteria

Criteria

Ages Eligible for Study:

N/A and Older

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Yes

Inclusion Criteria:

Study participant must be a health care provider who frequently refers or accepts oncologic patients to the ICU

Exclusion Criteria:

none

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Latino-American Critical Care Trial Network (LACTIN)	Houston	Texas	United States	77030
2	The University of Texas MD Anderson Cancer Center	Houston	Texas	United States	77030
3	5th International Oncology Course Conference	Manta	Manabí Province	Ecuador

Sponsors and Collaborators

M.D. Anderson Cancer Center

Investigators

Principal Investigator: Nisha Rathi, MD, UT MD Anderson Cancer Center

Study Documents (Full-Text)

None provided.

More Information

Additional Information:

The University of Texas (UT) MD Anderson Cancer Center Official Website

Publications

None provided.

Responsible Party:

M.D. Anderson Cancer Center

ClinicalTrials.gov Identifier:

NCT03401411

Other Study ID Numbers:

2009-0450

First Posted:

Jan 17, 2018

Last Update Posted:

Feb 28, 2018

Last Verified:

Feb 1, 2018

Studies a U.S. FDA-regulated Drug Product:

Studies a U.S. FDA-regulated Device Product:

Keywords provided by M.D. Anderson Cancer Center

Study Results

No Results Posted as of Feb 28, 2018