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Trial registered on ANZCTR


Registration number
ACTRN12625000140459
Ethics application status
Approved
Date submitted
18/01/2025
Date registered
7/02/2025
Date last updated
7/02/2025
Date data sharing statement initially provided
7/02/2025
Type of registration
Prospectively registered

Titles & IDs
Public title
'Exploring the impact on Emergency Department (ED) fast track stream patient flow metrics of an Advanced Scope Physiotherapy (ASP) service at St John of God Midland Public and Private Hospital ED'.
Scientific title
'Exploring the impact on Emergency Department (ED) fast track stream patient flow metrics of an Advanced Scope Physiotherapy (ASP) service at St John of God Midland Public and Private Hospital ED'.
Secondary ID [1] 313654 0
Nil known
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Emergency department presentation 336224 0
closed fractures 336225 0
musculoskeletal pain 336446 0
musculoskeletal injury 336447 0
Condition category
Condition code
Injuries and Accidents 332761 332761 0 0
Fractures
Injuries and Accidents 332762 332762 0 0
Other injuries and accidents
Musculoskeletal 332763 332763 0 0
Other muscular and skeletal disorders
Physical Medicine / Rehabilitation 332764 332764 0 0
Physiotherapy
Public Health 332765 332765 0 0
Health service research
Emergency medicine 332966 332966 0 0
Other emergency care

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
ASP's are primary contact practitioners in ED. They independently assess, diagnose and manage patients presenting to ED with closed musculoskeletal pain and/or injury. ASP's may seek input from other ED clinicians (doctors, nurses, other allied health workers) as required.
ASP's are involved in the care of the patient from the time of triage to discharge from the ED. For the purpose of this study, participants of the study and their ED presentation data will only be reviewed once discharged from ED.

5 week intervention period
Time period 2: 1 ASP rostered 8 hour shift from 8am to 4pm, and another ASP rostered 8 hour shift from 12noon to 8pm or 2pm to 10pm in vertical stream (fast track) at St John of God Midland Public and Private Hospital Emergency Department over 5 consecutive Mondays.
The ASP's involved in the study are all credentialed ASP's already working within the service. The ASP's working as part of the intervention will be working within their normal scope of practice, and function 'as per usual'. Nil additional training / preparation will be required for the ASP's to complete additional shifts which is the intervention of this study.

Patients streamed to fast track require medical care for less serious illnesses and injuries. Primarily Australasian Triage Scale (ATS) category 3-5 patients, fast track patients need to be ambulant.
Examples of patients streamed to fast track include:
- musculoskeletal pain (back pain)
- musculoskeletal injury (ankle sprain)
- open or closed fractures
- low risk abdominal pain
Intervention code [1] 330257 0
Treatment: Other
Comparator / control treatment
5 week control period (usual and current practice) prior to the 5 week intervention period.
Time period 1: 1 ASP rostered 8 hour shift from 8am to 4pm in vertical stream (fast track) at St John of God Midland Public and Private Hospital Emergency Department over 5 consecutive Mondays
Control group
Historical

Outcomes
Primary outcome [1] 340413 0
Wait time of ED vertical stream (fast track) patients from triage to be seen by clinician in minutes
Timepoint [1] 340413 0
Mean and standard deviation collected at end of 5 week control period (time period 1), and collected again at end of 5 week intervetion period (time period 2).
Primary outcome [2] 340414 0
Patient total length of stay in emergency department
Timepoint [2] 340414 0
Mean and standard deviation collected at end of 5 week control period (time period 1), and collected again at end of 5 week intervetion period (time period 2).
Primary outcome [3] 340415 0
Proportion of patients seen within the maximum time as indicated by the Australasian Triage Scale.
Timepoint [3] 340415 0
Percentages will be calculated at end of control period (time period 1) and intervention period (time period 2).
Secondary outcome [1] 443985 0
Proportion of patients who Did Not Wait - that is the percentage of patients who left the ED who had been triaged, but did not wait to be seen by a health professional
Timepoint [1] 443985 0
Calculated at end of control period (time period 1) and intervention period (time period 2).
Secondary outcome [2] 444298 0
Proportion of patients that met West Australian Access Target – the percentage of patients to be seen, transferred, admitted or discharged within four hours from ED
Timepoint [2] 444298 0
Calculated at end of control period (time period 1) and intervention period (time period 2).

Eligibility
Key inclusion criteria
All patients who present to SJGMPPH ED and triaged to fast track (vertical stream) over the study period will be included for the project.
Minimum age
5 Years
Maximum age
No limit
Sex
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
Non-fast track (vertical) stream ED patients

Study design
Purpose of the study
Treatment
Allocation to intervention
Non-randomised trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Open (masking not used)
Who is / are masked / blinded?



Intervention assignment
Other
Other design features
Pre-post design. 5 weeks of control / usual care will occur prior to 5 weeks of intervention care (additional ASP).
Phase
Not Applicable
Type of endpoint/s
Statistical methods / analysis
Interrupted time series analysis for primary outcome measures

Recruitment
Recruitment status
Not yet recruiting
Date of first participant enrolment
Anticipated
17/03/2025
Actual
Date of last participant enrolment
Anticipated
19/05/2025
Actual
Date of last data collection
Anticipated
21/05/2025
Actual
Sample size
Target
1000
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
WA

Funding & Sponsors
Funding source category [1] 318120 0
Hospital
Name [1] 318120 0
St John of God Midland Public and Private Hospital Health Management Committee Seed Funding Grant
Country [1] 318120 0
Australia
Primary sponsor type
Hospital
Name
St John of God Healthcare
Address
Country
Australia
Secondary sponsor category [1] 320500 0
None
Name [1] 320500 0
Address [1] 320500 0
Country [1] 320500 0

Ethics approval
Ethics application status
Approved
Ethics committee name [1] 316765 0
St John of God Health Care Human Research Ethics Committee
Ethics committee address [1] 316765 0
https://www.sjog.org.au/about-us/research/human-research-ethics-committee
Ethics committee country [1] 316765 0
Australia
Date submitted for ethics approval [1] 316765 0
01/12/2024
Approval date [1] 316765 0
08/01/2025
Ethics approval number [1] 316765 0

Summary
Brief summary
To explore the impact of the advanced scope physiotherapy (ASP) service on patient flow in the emergency department fast track stream and determine whether an additional ASP and expansion of hours impacts patient flow. An additional ASP will be rostered in ED over the intervention period and key emergency department (ED) patient flow metrics will be collected and compared to when there is only one ASP (usual care). The primary outcomes of ED patient flow metrics include time for patients to be seen, total length of stay, proportion of patients being seen in the recommended amount of time and proportion of patients meeting the four hour rule in ED.
Trial website
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 138946 0
Ms Aedin Shannon
Address 138946 0
St John of God Midland Public and Private Hospital, 1 Clayton Street Midland WA 6056
Country 138946 0
Australia
Phone 138946 0
+61 8 9462 5326
Fax 138946 0
Email 138946 0
[email protected]
Contact person for public queries
Name 138947 0
Aedin Shannon
Address 138947 0
St John of God Midland Public and Private Hospital, 1 Clayton Street Midland WA 6056
Country 138947 0
Australia
Phone 138947 0
+61 8 9462 5326
Fax 138947 0
Email 138947 0
[email protected]
Contact person for scientific queries
Name 138948 0
Kenny Kessler
Address 138948 0
St John of God Midland Public and Private Hospital, 1 Clayton Street Midland WA 6056
Country 138948 0
Australia
Phone 138948 0
+61 8 9462 5326
Fax 138948 0
Email 138948 0
[email protected]

Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
No/undecided IPD sharing reason/comment


What supporting documents are/will be available?




Results publications and other study-related documents

Documents added manually
No documents have been uploaded by study researchers.

Documents added automatically
No additional documents have been identified.