Implementation Of An ED Surge Management Platform: A Study Protocol

Abstract

\n Background Wait times and overcrowding are challenging emergency departments (EDs) around the world. To address these issues, a quality improvement program called SurgeCon was created to improve ED efficiency and patient satisfaction. This paper presents a framework for managing and evaluating the implementation of an ED surge management platform. Our framework builds on the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework to structure our approach and the Consolidated Framework for Implementation Research (CFIR) to guide our choice of outcome variables and scalability. Methods Four hospital EDs will receive the SurgeCon quality improvement program. Using a stepped wedge cluster design, each ED will be randomised to one of four start dates. Data will be collected before, during, and after the implementation. Guided by CFIR, we will measure ED key performance indicators (KPI), patient reported outcomes, and implementation outcomes related to SurgeCon’s scalability, adaptability, sustainability and overall costs. RE-AIM will be used to guide the assessment of SurgeCon. Participants in this study consist of patients who visit any of the four selected EDs during the study period, providers/staff, and health system managers. A mixed-methods approach will be utilized to evaluate implementation outcomes. Discussion This study will provide important insight into the implementation and evaluation techniques to enhance uptake of an ED surge-management platform. The proposed framework bridges research and practice by involving researchers, practitioners, and patients in the implementation and evaluation process, to produce an actionable framework that others can follow. We anticipate that the implementation approach would be generalizable to program implementations in other EDs.Trial Registration:Name of the registry: ClinicalTrials.govTrial registration number: NCT04789902Date of registration: 03/10/2021URL of trial registry record: https://clinicaltrials.gov/ct2/show/NCT04789902?cond=surgecon&draw=2&rank=1