Structured triage in the emergency department via intelligent assistant service OPTINOFA : Results of a multicenter, cluster-randomized and controlled interventional study in Germany
In Germany, a substantial reform of emergency care is strictly recommended. Regulation of patient flows into the ambulatory and stationary sectors remains a major issue.In the OPTINOFA project funded by Innovationsfunds, a new triage system was developed for a structured primary evaluation of both u...
Gespeichert in:
| Veröffentlicht in: | Medizinische Klinik, Intensivmedizin und Notfallmedizin Intensivmedizin und Notfallmedizin, 2024-12 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | ger |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | |
| container_start_page | |
| container_title | Medizinische Klinik, Intensivmedizin und Notfallmedizin |
| container_volume | |
| creator | Blaschke, Sabine Dormann, Harald Somasundaram, Rajan Dodt, Christoph Graeff, Ingo Busch, Hans-Jörg Erdmann, Bernadett Wieckenberg, Marc Haedicke, Christoph Esslinger, Katrin Nyoungui, Elisabeth Friede, Tim Walcher, Felix Talamo, Julia Wolff, Julia K |
| description | In Germany, a substantial reform of emergency care is strictly recommended. Regulation of patient flows into the ambulatory and stationary sectors remains a major issue.In the OPTINOFA project funded by Innovationsfunds, a new triage system was developed for a structured primary evaluation of both urgency and care level of emergency cases. OPTINOFA was evaluated in a cluster-randomized, controlled multicenter trial using a stepped-wedge design in eight emergency departments (ED) from 1 July 2019 to 31 May 2021. Additionally, data from one ED were used for comparison of temporal changes without intervention. The primary study endpoint represented the increase of patient transfers to the ambulatory sector; secondary endpoints included the outcome, process and quality indicators as well as mean emergency care costs.In the study, 46,558 emergency cases were included in the control period and 37,485 emergency cases in the intervention period. Concerning the primary endpoint, a significant increase of transfers to the ambulatory sector were detected in the per-protocol EDs (p |
| doi_str_mv | 10.1007/s00063-024-01229-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_3146852156</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3146852156</sourcerecordid><originalsourceid>FETCH-LOGICAL-p921-a3e20d7a94ca12958a07f736bc0060819e96d3d55713793f667b0235f381389d3</originalsourceid><addsrcrecordid>eNpNkEtOwzAQQC0EolXpBVggL1kQ8KdxYnYVoqVSRRF0H7nxpBjlU2ynUjgNt2DPyXBEkVj5jeaN54PQOSXXlJDkxhFCBI8Im0SEMiYjcYSGjEoeCcbE8T8eoLFzb6T3CYkTcooGXIqUUM6H6OvF2zb3rQWNvTVqC9jU2L8ChgrsFuq8wxp2yvoKao_3RoW8h7I02z5WzhnnVSAHdm9ywKun9eJxNZviW_wMri29w02B1fdnFTgIodhe4bxsXYDIqlo3lfkI3QPhvKm9bcoyhH0Xuw-6aWpVYudb3fWjzcFWqu7O0EmhSgfjwztC69n9-u4hWq7mi7vpMtpJRiPFgRGdKDnJFWUyThVJioSLTd4fI6USpNBcx3FCeSJ5IUSyIYzHBU8pT6XmI3T5--3ONu8tOJ9VxuVhfVVD07qM04lIY0ZjEdSLg9puKtDZzppK2S77uzX_AZnOhgQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3146852156</pqid></control><display><type>article</type><title>Structured triage in the emergency department via intelligent assistant service OPTINOFA : Results of a multicenter, cluster-randomized and controlled interventional study in Germany</title><source>SpringerLink Journals - AutoHoldings</source><creator>Blaschke, Sabine ; Dormann, Harald ; Somasundaram, Rajan ; Dodt, Christoph ; Graeff, Ingo ; Busch, Hans-Jörg ; Erdmann, Bernadett ; Wieckenberg, Marc ; Haedicke, Christoph ; Esslinger, Katrin ; Nyoungui, Elisabeth ; Friede, Tim ; Walcher, Felix ; Talamo, Julia ; Wolff, Julia K</creator><creatorcontrib>Blaschke, Sabine ; Dormann, Harald ; Somasundaram, Rajan ; Dodt, Christoph ; Graeff, Ingo ; Busch, Hans-Jörg ; Erdmann, Bernadett ; Wieckenberg, Marc ; Haedicke, Christoph ; Esslinger, Katrin ; Nyoungui, Elisabeth ; Friede, Tim ; Walcher, Felix ; Talamo, Julia ; Wolff, Julia K ; OPTINOFA Study Group</creatorcontrib><description>In Germany, a substantial reform of emergency care is strictly recommended. Regulation of patient flows into the ambulatory and stationary sectors remains a major issue.In the OPTINOFA project funded by Innovationsfunds, a new triage system was developed for a structured primary evaluation of both urgency and care level of emergency cases. OPTINOFA was evaluated in a cluster-randomized, controlled multicenter trial using a stepped-wedge design in eight emergency departments (ED) from 1 July 2019 to 31 May 2021. Additionally, data from one ED were used for comparison of temporal changes without intervention. The primary study endpoint represented the increase of patient transfers to the ambulatory sector; secondary endpoints included the outcome, process and quality indicators as well as mean emergency care costs.In the study, 46,558 emergency cases were included in the control period and 37,485 emergency cases in the intervention period. Concerning the primary endpoint, a significant increase of transfers to the ambulatory sector were detected in the per-protocol EDs (p < 0.001, odds ratio = 10.59). Waiting times were significantly reduced by an average 20 min in the intervention phase. Furthermore, a stable admission rate was found within 3 days after initial ED presentation. Cost analysis revealed no increase of treatment expenses within 28 days after ED admission.In this project a valid assistant service for structured primary evaluation of urgency and care level was successfully developed for emergency cases and served as a digital triage instrument with interoperable format. Clinical trial results revealed great potential for the OPTINOFA triage system to control patient flows in emergency and acute medicine.</description><identifier>ISSN: 2193-6226</identifier><identifier>EISSN: 2193-6226</identifier><identifier>DOI: 10.1007/s00063-024-01229-6</identifier><identifier>PMID: 39680133</identifier><language>ger</language><publisher>Germany</publisher><ispartof>Medizinische Klinik, Intensivmedizin und Notfallmedizin, 2024-12</ispartof><rights>2024. The Author(s).</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0001-8800-7554</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39680133$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Blaschke, Sabine</creatorcontrib><creatorcontrib>Dormann, Harald</creatorcontrib><creatorcontrib>Somasundaram, Rajan</creatorcontrib><creatorcontrib>Dodt, Christoph</creatorcontrib><creatorcontrib>Graeff, Ingo</creatorcontrib><creatorcontrib>Busch, Hans-Jörg</creatorcontrib><creatorcontrib>Erdmann, Bernadett</creatorcontrib><creatorcontrib>Wieckenberg, Marc</creatorcontrib><creatorcontrib>Haedicke, Christoph</creatorcontrib><creatorcontrib>Esslinger, Katrin</creatorcontrib><creatorcontrib>Nyoungui, Elisabeth</creatorcontrib><creatorcontrib>Friede, Tim</creatorcontrib><creatorcontrib>Walcher, Felix</creatorcontrib><creatorcontrib>Talamo, Julia</creatorcontrib><creatorcontrib>Wolff, Julia K</creatorcontrib><creatorcontrib>OPTINOFA Study Group</creatorcontrib><title>Structured triage in the emergency department via intelligent assistant service OPTINOFA : Results of a multicenter, cluster-randomized and controlled interventional study in Germany</title><title>Medizinische Klinik, Intensivmedizin und Notfallmedizin</title><addtitle>Med Klin Intensivmed Notfmed</addtitle><description>In Germany, a substantial reform of emergency care is strictly recommended. Regulation of patient flows into the ambulatory and stationary sectors remains a major issue.In the OPTINOFA project funded by Innovationsfunds, a new triage system was developed for a structured primary evaluation of both urgency and care level of emergency cases. OPTINOFA was evaluated in a cluster-randomized, controlled multicenter trial using a stepped-wedge design in eight emergency departments (ED) from 1 July 2019 to 31 May 2021. Additionally, data from one ED were used for comparison of temporal changes without intervention. The primary study endpoint represented the increase of patient transfers to the ambulatory sector; secondary endpoints included the outcome, process and quality indicators as well as mean emergency care costs.In the study, 46,558 emergency cases were included in the control period and 37,485 emergency cases in the intervention period. Concerning the primary endpoint, a significant increase of transfers to the ambulatory sector were detected in the per-protocol EDs (p < 0.001, odds ratio = 10.59). Waiting times were significantly reduced by an average 20 min in the intervention phase. Furthermore, a stable admission rate was found within 3 days after initial ED presentation. Cost analysis revealed no increase of treatment expenses within 28 days after ED admission.In this project a valid assistant service for structured primary evaluation of urgency and care level was successfully developed for emergency cases and served as a digital triage instrument with interoperable format. Clinical trial results revealed great potential for the OPTINOFA triage system to control patient flows in emergency and acute medicine.</description><issn>2193-6226</issn><issn>2193-6226</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNpNkEtOwzAQQC0EolXpBVggL1kQ8KdxYnYVoqVSRRF0H7nxpBjlU2ynUjgNt2DPyXBEkVj5jeaN54PQOSXXlJDkxhFCBI8Im0SEMiYjcYSGjEoeCcbE8T8eoLFzb6T3CYkTcooGXIqUUM6H6OvF2zb3rQWNvTVqC9jU2L8ChgrsFuq8wxp2yvoKao_3RoW8h7I02z5WzhnnVSAHdm9ywKun9eJxNZviW_wMri29w02B1fdnFTgIodhe4bxsXYDIqlo3lfkI3QPhvKm9bcoyhH0Xuw-6aWpVYudb3fWjzcFWqu7O0EmhSgfjwztC69n9-u4hWq7mi7vpMtpJRiPFgRGdKDnJFWUyThVJioSLTd4fI6USpNBcx3FCeSJ5IUSyIYzHBU8pT6XmI3T5--3ONu8tOJ9VxuVhfVVD07qM04lIY0ZjEdSLg9puKtDZzppK2S77uzX_AZnOhgQ</recordid><startdate>20241216</startdate><enddate>20241216</enddate><creator>Blaschke, Sabine</creator><creator>Dormann, Harald</creator><creator>Somasundaram, Rajan</creator><creator>Dodt, Christoph</creator><creator>Graeff, Ingo</creator><creator>Busch, Hans-Jörg</creator><creator>Erdmann, Bernadett</creator><creator>Wieckenberg, Marc</creator><creator>Haedicke, Christoph</creator><creator>Esslinger, Katrin</creator><creator>Nyoungui, Elisabeth</creator><creator>Friede, Tim</creator><creator>Walcher, Felix</creator><creator>Talamo, Julia</creator><creator>Wolff, Julia K</creator><scope>NPM</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8800-7554</orcidid></search><sort><creationdate>20241216</creationdate><title>Structured triage in the emergency department via intelligent assistant service OPTINOFA : Results of a multicenter, cluster-randomized and controlled interventional study in Germany</title><author>Blaschke, Sabine ; Dormann, Harald ; Somasundaram, Rajan ; Dodt, Christoph ; Graeff, Ingo ; Busch, Hans-Jörg ; Erdmann, Bernadett ; Wieckenberg, Marc ; Haedicke, Christoph ; Esslinger, Katrin ; Nyoungui, Elisabeth ; Friede, Tim ; Walcher, Felix ; Talamo, Julia ; Wolff, Julia K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p921-a3e20d7a94ca12958a07f736bc0060819e96d3d55713793f667b0235f381389d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>ger</language><creationdate>2024</creationdate><toplevel>online_resources</toplevel><creatorcontrib>Blaschke, Sabine</creatorcontrib><creatorcontrib>Dormann, Harald</creatorcontrib><creatorcontrib>Somasundaram, Rajan</creatorcontrib><creatorcontrib>Dodt, Christoph</creatorcontrib><creatorcontrib>Graeff, Ingo</creatorcontrib><creatorcontrib>Busch, Hans-Jörg</creatorcontrib><creatorcontrib>Erdmann, Bernadett</creatorcontrib><creatorcontrib>Wieckenberg, Marc</creatorcontrib><creatorcontrib>Haedicke, Christoph</creatorcontrib><creatorcontrib>Esslinger, Katrin</creatorcontrib><creatorcontrib>Nyoungui, Elisabeth</creatorcontrib><creatorcontrib>Friede, Tim</creatorcontrib><creatorcontrib>Walcher, Felix</creatorcontrib><creatorcontrib>Talamo, Julia</creatorcontrib><creatorcontrib>Wolff, Julia K</creatorcontrib><creatorcontrib>OPTINOFA Study Group</creatorcontrib><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Medizinische Klinik, Intensivmedizin und Notfallmedizin</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Blaschke, Sabine</au><au>Dormann, Harald</au><au>Somasundaram, Rajan</au><au>Dodt, Christoph</au><au>Graeff, Ingo</au><au>Busch, Hans-Jörg</au><au>Erdmann, Bernadett</au><au>Wieckenberg, Marc</au><au>Haedicke, Christoph</au><au>Esslinger, Katrin</au><au>Nyoungui, Elisabeth</au><au>Friede, Tim</au><au>Walcher, Felix</au><au>Talamo, Julia</au><au>Wolff, Julia K</au><aucorp>OPTINOFA Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Structured triage in the emergency department via intelligent assistant service OPTINOFA : Results of a multicenter, cluster-randomized and controlled interventional study in Germany</atitle><jtitle>Medizinische Klinik, Intensivmedizin und Notfallmedizin</jtitle><addtitle>Med Klin Intensivmed Notfmed</addtitle><date>2024-12-16</date><risdate>2024</risdate><issn>2193-6226</issn><eissn>2193-6226</eissn><abstract>In Germany, a substantial reform of emergency care is strictly recommended. Regulation of patient flows into the ambulatory and stationary sectors remains a major issue.In the OPTINOFA project funded by Innovationsfunds, a new triage system was developed for a structured primary evaluation of both urgency and care level of emergency cases. OPTINOFA was evaluated in a cluster-randomized, controlled multicenter trial using a stepped-wedge design in eight emergency departments (ED) from 1 July 2019 to 31 May 2021. Additionally, data from one ED were used for comparison of temporal changes without intervention. The primary study endpoint represented the increase of patient transfers to the ambulatory sector; secondary endpoints included the outcome, process and quality indicators as well as mean emergency care costs.In the study, 46,558 emergency cases were included in the control period and 37,485 emergency cases in the intervention period. Concerning the primary endpoint, a significant increase of transfers to the ambulatory sector were detected in the per-protocol EDs (p < 0.001, odds ratio = 10.59). Waiting times were significantly reduced by an average 20 min in the intervention phase. Furthermore, a stable admission rate was found within 3 days after initial ED presentation. Cost analysis revealed no increase of treatment expenses within 28 days after ED admission.In this project a valid assistant service for structured primary evaluation of urgency and care level was successfully developed for emergency cases and served as a digital triage instrument with interoperable format. Clinical trial results revealed great potential for the OPTINOFA triage system to control patient flows in emergency and acute medicine.</abstract><cop>Germany</cop><pmid>39680133</pmid><doi>10.1007/s00063-024-01229-6</doi><orcidid>https://orcid.org/0000-0001-8800-7554</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2193-6226 |
| ispartof | Medizinische Klinik, Intensivmedizin und Notfallmedizin, 2024-12 |
| issn | 2193-6226 2193-6226 |
| language | ger |
| recordid | cdi_proquest_miscellaneous_3146852156 |
| source | SpringerLink Journals - AutoHoldings |
| title | Structured triage in the emergency department via intelligent assistant service OPTINOFA : Results of a multicenter, cluster-randomized and controlled interventional study in Germany |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-13T15%3A31%3A51IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Structured%20triage%20in%20the%20emergency%20department%20via%20intelligent%20assistant%20service%20OPTINOFA%20:%20Results%20of%20a%C2%A0multicenter,%20cluster-randomized%20and%20controlled%20interventional%20study%20in%20Germany&rft.jtitle=Medizinische%20Klinik,%20Intensivmedizin%20und%20Notfallmedizin&rft.au=Blaschke,%20Sabine&rft.aucorp=OPTINOFA%20Study%20Group&rft.date=2024-12-16&rft.issn=2193-6226&rft.eissn=2193-6226&rft_id=info:doi/10.1007/s00063-024-01229-6&rft_dat=%3Cproquest_pubme%3E3146852156%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3146852156&rft_id=info:pmid/39680133&rfr_iscdi=true |