Cancer, Emergencies
Conditions
Brief summary
The goal of this single center prospective cross-sectional study is to identify the facilitators and barriers in the course of the disease that starts when symptoms first arise until patients with solid and hematologic malignancies arrive in the emergency department (ED). The main question it aims to answer are: Is there a potential relation between the lag-time and the ED length of stay (LOS) and the chance of admission. Participants will be asked to participate in a one-time interview, that focusses on the pre-admission process.
Detailed description
The goal of this single center prospective cross-sectional study is to identify the facilitators and barriers in the course of the disease that starts when symptoms first arise until patients with solid and hematologic malignancies arrive in the emergency department (ED). The main question it aims to answer are: Is there a potential relation between the lag-time and the emergency department length of stay and the chance of admission. Participants will be asked to participate in a one-time interview, that focusses on the pre-admission process. The interview focuses on several parts of the (pre-)admission process: The first part is regarding the timeline that led to an ED visit. The investigators will establish, when and which symptoms were first detected. The second part are regarding the number and type of health care workers that were contacted before visiting the ED. The third part will be about the actions that were taken before the ED visit.
Interventions
BEHAVIORALEmergency department cancer patients interview
The interview focuses on several parts of the (pre-)admission process: The first part is regarding the barriers and facilitators encountered during the (pre-)admission process. The second part will focus on the timeline that led to an emergency department (ED) visit. It will be established when and which symptoms were first detected. The third part is regarding the number and type of health care workers that were contacted before visiting the ED. The fourth part will be about the actions and considerations taken before the ED visit.
Sponsors
Erasmus Medical Center
Study design
Observational model
CASE_ONLY
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients with solid or hematological malignancies and receiving systemic therapy or having received systemic therapy within the last 3 months. * Presented at or admitted from the emergency department for the oncology, hematology, neuro- or lung-oncology clinical unit. * Awake and conscious. * Possible to answer questions within 48 hours after presentation at the emergency department (ED).
Exclusion criteria
* \<18 years old * Only received a surgical intervention as cancer treatment * Admitted to the ED for the surgical department * Not willing or able to give written informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| clusters of barriers experienced by cancer patients. | Through study completion, an average of 6 months | Different (sub)clusters of barriers experienced by cancer patients visiting the ED |
| Clusters of facilitators experienced by cancer patients. | Through study completion, an average of 6 months | Different (sub)clusters of facilitators experienced by cancer patients visiting the emergency department (ED) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time-to-present | Through study completion, an average of 6 months | The time between the first contact with a healthcare professional and the presentation at the ED |
| Difference in group average lag-time between day, evening and night | Through study completion, an average of 6 months | Difference in group average lag-time between day, evening and night |
| Difference in group average lag-time between weekdays (Monday 08:00 till Friday 23:59) and weekend (Saturday 00:00 and Monday 7:59) | Through study completion, an average of 6 months | Difference in group average lag-time between weekdays (Monday 08:00 till Friday 23:59) and weekend (Saturday 00:00 and Monday 7:59) |
| Correlation between number of contacted healthcare providers before presentation at the ED and the lag- time. | Through study completion, an average of 6 months | Correlation between number of contacted healthcare providers before presentation at the ED and the lag- time. |
| Willingness to participate | Through study completion, an average of 6 months | the percentage of people that participated in this study in comparison to the people approached for this study. |
| Lag-time | Through study completion, an average of 6 months | The time between the first onset of symptoms and a visit to the ED. |
| Time-to-speak | Through study completion, an average of 6 months | The time between the first notice of symptoms and the first time these complaints were spoken out to the primary giver |
| Disposition | Through study completion, an average of 6 months | The outcome of a visit to the ED, being either admission or home |
| Patient characteristics | Through study completion, an average of 6 months | Age, sex, type of cancer, type of complaint, triage category, number of prior visits |
| Correlation between lag-time and ED-LOS | Through study completion, an average of 6 months | Correlation between lag-time and ED-LOS |
| Correlation between lag-time and disposition | Through study completion, an average of 6 months | Correlation between lag-time and disposition |
| Correlation between lag-time and patient characteristics | Through study completion, an average of 6 months | Correlation between lag-time and patient characteristics |
| ED crowding | Through study completion, an average of 6 months | Measure of business of the ED, composed of the number of patients in the ED and the color coding used for crowding |
| ED length of stay (LOS) | Through study completion, an average of 6 months | The time a patient spends in the ED |
| Time-to-contact | Through study completion, an average of 6 months | The time between the first time complaints are spoken out and contact is made with a healthcare professional |
Countries
Netherlands
Outcome results
None listed