Optimised Patient Transfer using an Innovative Multidisciplinary Assessment in the Canton Aargau (OPTIMA)

ISRCTN	ISRCTN76703125
DOI	https://doi.org/10.1186/ISRCTN76703125
Secondary identifying numbers	N/A

Submission date: 09/12/2009
Registration date: 17/02/2010
Last edited: 17/02/2010

Recruitment status: No longer recruiting
Overall study status: Completed
Condition category: Respiratory

Prospectively registered

Protocol

Statistical analysis plan

Results

Individual participant data

Record updated in last year

Plain English summary of protocol

Not provided at time of registration

Contact information

Dr Werner Albrich
Scientific

Kantonsspital Aarau
Tellstrasse
Aarau
5001
Switzerland

Study information

Study design	Observational quality-control analysis of current practice
Primary study design	Observational
Secondary study design	Other
Study setting(s)	Hospital
Study type	Other
Participant information sheet	Not available in web format, please use the contact details below to request a patient information sheet
Scientific title	Optimised Patient Transfer using an Innovative Multidisciplinary Assessment in the Canton Aargau (OPTIMA) : An observational quality control trial
Study acronym	OPTIMA
Study objectives	To develop appropriate triage pathways based on medical, nursing and psychosocial criteria in patients with lower respiratory tract infections
Ethics approval(s)	The Canton Aargau Cantonal Ethics Committee (Kantonale Ethikkommission Kanton Aargau) approved on the 10th of November (ref: EK 2009/074)
Health condition(s) or problem(s) studied	Respiratory tract infections
Intervention	Currently, most patients with lower respiratory tract infections, who are seen and evaluated in our Emergency Department, are generally admitted to hospital regardless of medical, nursing and psychosocial criteria. Clinical severity scores such as CURB65 and Pneumonia Severity Index (PSI), the levels of biomarkers, nursing risk assessments and patient's and relatives' preferences are not strictly applied and followed, but will be assessed in this observational analysis. Based on this patients will be classified into low, intermediate, high and very high risks corresponding to virtual triage into ambulatory, post-peracute care, spa treatment, nurse-led unit or traditional acute hospital care. Patients will be followed up for 30 days after presentation. The duration of the observation period is from November 2009 until May 2010.
Intervention type	Other
Primary outcome measure	To define the percentage of allocated patients into low, intermediate, high and very high risks based on medical, nursing and psychosocial criteria corresponding to virtual triage into ambulatory, post-peracute care, spa treatment, nurse-led unit or traditional acute hospital care
Secondary outcome measures	1. Correlation of biomarkers, clinical and nursing scores (separately and in combination) with patients' outcomes (hospital mortality, ICU requirement and severe complications such as empyema, lung abscess, development of acute respiratory distress syndrome [ARDS], persistence or development of pneumonia) and site of care decisions 2. Identification and adaptation of medical, nursing and psychosocial criteria for triage decisions using biomarkers, clinical scores and functionality assessments, patients' and relatives` preferences 3. Testing the usefulness and feasibility of functional status and risk assessment tools as a surrogate marker for nursing requirements for risk-stratification 4. Comparison of the post-acute care discharge score with biomarkers and other clinical and functional assessment tools on day 3 5. External validation of the 5 day-1-items identified as predictive for post-acute care discharge 6. Identification of patients' and relatives' information needs 7. Cost-effectiveness of innovative pathways based on case-based lump sum (Fallpauschale) of entire treatment pathway on patient-level 8. Identification of patients' and families' preferences for site of care 9. Determination of current length of acute hospitalisation 10. Identification of medical and functional/nursing and psychosocial criteria to define stability for timely transfer to home or post-peracute care facilities (spa treatment or immediate post-peracute care in specialized facilities or NLU) 11. Determination of time to stability for transfer to post-peracute care facilities 12. Determination of proportion of patients eligible for pulmonary rehabilitation and time until eligibility
Overall study start date	10/11/2009
Completion date	31/10/2010

Eligibility

Participant type(s)	Patient
Age group	Adult
Lower age limit	18 Years
Sex	Both
Target number of participants	450
Key inclusion criteria	1. Age ≥ 18 years 2. Admission to Emergency Department (ED) of acute care hospital (Kantonsspital Aarau, Klinik Barmelweid) for acute lower respiratory tract infections
Key exclusion criteria	Does not match inclusion criteria
Date of first enrolment	10/11/2009
Date of final enrolment	31/10/2010

Locations

Countries of recruitment

Switzerland

Study participating centre

Kantonsspital Aarau

Aarau
5001
Switzerland

Sponsor information

Kantonsspital Aarau (Switzerland)
Hospital/treatment centre

Tellstrasse
Aarau
5001
Switzerland

Website	http://www.ksa.ch/
"ROR"	https://ror.org/056tb3809

Funders

Funder type

Hospital/treatment centre

Kantonsspital Aarau (Swizterland) - investigator-driven

No information available

Canton AargauHealth Department (Gesundheitsdepartement des Kantons Aargau) - local government grant

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to share	No
IPD sharing plan summary	Not provided at time of registration
Publication and dissemination plan	Not provided at time of registration
IPD sharing plan