Evaluation of the Access to Healthcare Service
ConditionEmergency Service, Hospital
Trial statusNot yet recruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
Age18+
SponsorUniversity Hospital, Rouen
About this trial
The Healthcare Access Service (SAS) of the Emergency Department of the CHG du Havre is a telephone regulation (i.e., orientation) service for users of Le Havre. Access to this service, during a call, gives access to a Medical Regulation Assistant (ARM) (first contact) who determines, in less than 30 seconds, the degree of urgency applicable to the "caller" in order to direct the latter to the "primary care" channel or the "urgent medical assistance" channel. Thus, in the context of a non-life-threatening emergency, this service allows access during the day to a consultation with a healthcare professional. When their primary care physician is not available, the "caller" is directed by a Medical Regulation Assistant (ARM) to an Unscheduled Care Operator (OSNP) who can provide medical advice, offer a teleconsultation, or direct them, depending on the situation, to an unscheduled care consultation in an office, at home, or at a health center. This service therefore allows for patient referrals and gives patients direct access to healthcare professionals known as "performers" of primary care (doctor, midwife, dentist) within very short timeframes (most often during the day, and 48 hours at the latest). This medical regulation is made possible through the use of a shared calendar between independent healthcare professionals and the healthcare access service (SAS). In the event of a life-threatening emergency, the "caller" is directed by the Medical Regulation Assistant (ARM) to an emergency Medical Regulation Assistant (ARM) who assesses the actual degree of urgency, the medical needs and the possibility of triggering the SAMU intervention. Before its implementation, the patient journey was complicated by the lack of a link between regulation and so-called "field" medical professionals, now called "performers" of primary care. Indeed, the initial so-called "standard" regulation system did not have a "primary care" referral system (with very rapid appointments to primary care for semi-emergencies (unscheduled community care)), potentially saving recourse to emergency services or medical time in situations not requiring medical advice (request for contact details of on-call pharmacy).
Eligibility criteria
This trial accepts healthy volunteersQualifiers
All calls to 116-117 or 15 in the Le Havre area over the 40 study periods,
Non-opposition. Patients with a life-threatening emergency will be included in the primary analysis, even though there will be no pseudo-randomization of the systems for them. They are therefore included in the study.
Non-opposition of patients who used the SNP call for the primary analysis,
Randomly selected by sampling calls to 116-117 or 15 made over the study periods defined by the protocol.
Disqualifiers
Refusal to participate,
Non-French speaking.
Minor caller
Refusal to participate (patient or caller or both),
Trial population
Users of the health system: The concept of users applies not only to the sick person and their loved ones but, more broadly, to any actual or potential user of the health system, in the health and medico-social fields, in establishments as well as in outpatient care or in home care
Trial design
Design model
Other
Time perspective
Prospective
Treatments tested in this trial
control group ("standard" regulation device)
Other interventionEvaluate the time spent in the emergency room of patients referred to the emergency room by the "standard" regulation system
intervention group Access to Care Service "SAS"
Other interventionEvaluate the time spent in the emergency room of patients referred to the emergency room by the Emergency Care Access Service (SAS)
Treatment groups
No treatment groups listed
Trial outcomes
Primary outcomes
1
Evaluate the savings in emergency room use attributable to the regulation system integrating the SAS compared to the standard control device
Assessment of referral to an emergency department by the regulating physician who treated the patient (with or without urgent medical transport) by telephone call.
Time frame
day 7Secondary outcomes
1
Description of the guidance given by the regulating physician in each of the devices (secondary judgment criterion no. 1)
The patient's orientation following the call (medical advice) will be recorded and evaluated.
Time frame
Day 72
Description of the guidance given by the regulating physician in each of the devices (secondary judgment criterion no. 1)
The patient's orientation following the call (appointment with a healthcare professional) will be recorded and evaluated.
Time frame
Day 73
Assessment of the patient's compliance rate with the guidance given by the regulating physician (secondary judgment criterion no. 2)
The patient's compliance with the guidance given by the private regulating physician will be recorded and evaluated.
Time frame
Day 74
Assessment of the patient's compliance rate with the guidance given by the regulating physician (secondary judgment criterion no. 2)
The patient's compliance with the guidance given by the hospital regulating physician will be recorded and evaluated.
Time frame
Day 7Sponsors and contacts
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Source ClinicalTrials.gov
This trial is not recruiting at the moment. You can still explore other options: