Understanding corridor care in UK emergency departments
| ISRCTN | ISRCTN16396025 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN16396025 |
| IRAS number | 343816 |
| Secondary identifying numbers | CPMS 65013 |
- Submission date
- 10/01/2025
- Registration date
- 09/05/2025
- Last edited
- 09/05/2025
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Other
Plain English summary of protocol
Background and study aims
Crowding in emergency departments leads to patient care in areas not originally designed for this use, known as “escalation areas”. This includes repurposed clinical areas and non-clinical areas, such as hospital corridors. A standardised definition of this umbrella term is yet to be generated. To date, there is no evidence describing how many patients are cared for in such environments, who these patients are and any effect on longer-term outcomes for patients with this experience. This study aims to address these evidence gaps by:
1. Defining emergency department escalation areas
2. Estimating the number of patients cared for in escalation areas
3. Describing which patients experience escalation area care
The results will evidence the scale of crowding in UK emergency departments and help to inform policy debate about resource allocation to emergency care. It will also support future research into the effect of escalation area care on patient outcomes.
Who can participate?
Patients presenting to the emergency department who spend some or all of their stay in an escalation area or who are admitted to hospital without spending time in an escalation area.
What does the study involve?
The study involves no change to the tests carried out or treatment received. It involves the collection of information that is recorded as part of the routine care provided to the relevant patients.
What are the possible benefits and risks of participating?
There is no anticipated benefit to individual patients taking part in this study. There is the potential for future benefit to participants and other healthcare users if the findings are used to inform the future use of escalation areas and how care is delivered in these areas. As there is no change to tests or treatment as part of the study, and all information used is recorded as part of routine clinical care, there is no additional risk to participants in terms of the care they receive. There are small privacy and confidentiality risks that are addressed in the manner in which data is collected and stored
Where is the study run from?
The study is sponsored by North Bristol NHS Trust (UK). It is led by the UK Royal College of Emergency Medicine (RCEM) Trainee Emergency Research Network (TERN). The chief investigator for the study is based at the University of Bristol (UK)
When is the study starting and how long is it expected to run for?
March 2024 to May 2025
Who is funding the study?
The Royal College of Emergency Medicine (UK)
Who is the main contact?
Dr Ben Clarke (TERN Fellow), tern@rcem.ac.uk
Contact information
Public, Scientific, Principal Investigator
University of Bristol
Bristol
BS8 1QU
United Kingdom
 ORCID ID |
0000-0003-4991-974X |
|---|---|
| tom.roberts@bristol.ac.uk |
Study information
| Study design | Multi-centre observational cohort study with a combination of prospective and retrospective recruitment |
|---|---|
| Primary study design | Observational |
| Secondary study design | Delphi study |
| Study setting(s) | Hospital |
| Study type | Safety |
| Participant information sheet | Not available in web format, please use contact details to request a participant information sheet |
| Scientific title | Understanding escalation area and corridor care in UK emergency departments: an observational cohort and Delphi study |
| Study acronym | UnCorKED |
| Study objectives | What proportion of Emergency Department patients are being cared for in escalation areas and who are they? |
| Ethics approval(s) |
Approved 01/12/2024, London - Brighton & Sussex Research Ethics Committee (2 Redman Place, London, E20 1JQ, United Kingdom; +44 (0)2071048202; brightonandsussex.rec@hra.nhs.uk), ref: 24/LO/0837 |
| Health condition(s) or problem(s) studied | UK Emergency Department use of escalation areas |
| Intervention | Multicentre observational cohort study utilising a 'snapshot' approach to identify the proportion of patients within UK emergency departments who are being looked after in the escalation area. Data will be collected at the departmental and individual patient levels. The potential cohort for this study is all patients in the ED at each of the five snapshots. These snapshots will be spread out over a 2-week period (with at least 48 hours between timepoints) from 3rd to 16th March 2025. From this cohort, any patient who spends any time in an escalation area OR does not spend any time in an escalation area and subsequently is deemed to require admission to hospital will be included in the study. This is a purely observational study so there is no change to any patient's management. The researchers will complete follow-up data collection in up to 28 days. |
| Intervention type | Other |
| Primary outcome measure | The proportion of patients in UK Emergency Departments having care provided in escalation areas, prospectively collected at sites, performed at each of the five snapshots spread out over a 2-week period (with at least 48 hours between timepoints) from 3rd to 16th March 2025 |
| Secondary outcome measures | 1. Demographics of patients within UK Emergency Departments who are being looked after in escalation areas, collected from the electronic health record for each eligible patient at each snapshot 2. 28-day hospital length of stay and mortality rates for patients who receive care in escalation areas, collected from the electronic health record for each eligible patient at each snapshot 3. Type of escalation area(s) experienced, collected from the electronic health record for each eligible patient at each snapshot 4. Time spent in escalation areas, collected from the electronic health record for each eligible patient at each snapshot 5. ED diagnosis, collected from the electronic health record for each eligible patient at each snapshot 6. ED disposition, collected from the electronic health record for each eligible patient at each snapshot These five snapshots will be spread out over a 2-week period (with at least 48 hours between timepoints) from 3rd to 16th March 2025 |
| Overall study start date | 28/03/2024 |
| Completion date | 31/05/2025 |
Eligibility
| Participant type(s) | Patient |
|---|---|
| Age group | All |
| Sex | Both |
| Target number of participants | 10000 |
| Key inclusion criteria | Any patient present in the ED at the recruitment time points, who experience ED escalation area care during their ED stay or are admitted to hospital. Escalation areas will be defined for the purposes of identifying eligible patients as any area not routinely used unless the capacity of the usual ED geographical footprint is exceeded. |
| Key exclusion criteria | Does not meet the inclusion criteria |
| Date of first enrolment | 03/03/2025 |
| Date of final enrolment | 16/03/2025 |
Locations
Countries of recruitment
- England
- Northern Ireland
- Scotland
- United Kingdom
- Wales
Study participating centres
Skipton Road
Steeton
Keighley
BD20 6TD
United Kingdom
Cwmbran
NP44 8YN
United Kingdom
Westbury-on-trym
Bristol
BS10 5NB
United Kingdom
Sponsor information
Hospital/treatment centre
Research & Development
North Bristol NHS Trust
Level 3, Learning & Research Building
Southmead Hospital
Westbury-on-Trym
Bristol
BS10 5NB
England
United Kingdom
| Phone | +44 (0)117 4149330 |
|---|---|
| research@nbt.nhs.uk | |
| Website | http://www.nbt.nhs.uk/ |
"ROR" |
https://ror.org/036x6gt55 |
Funders
Funder type
University/education
Private sector organisation / Universities (academic only)
- Alternative name(s)
- RCEM
- Location
- United Kingdom
Results and Publications
| Intention to publish date | 03/03/2026 |
|---|---|
| Individual participant data (IPD) Intention to share | No |
| IPD sharing plan summary | Data sharing statement to be made available at a later date |
| Publication and dissemination plan | The results of this study will be submitted for publication in an appropriate peer reviewed journal. They will be presented at emergency care focussed conferences. In addition to this they will be disseminated by social media and the TERN website. |
| IPD sharing plan | The data-sharing plans for the current study are unknown and will be made available at a later date |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Protocol file | version 6.0 | 10/02/2025 | 28/03/2025 | No | No |
Additional files
Editorial Notes
13/01/2025: Study's existence confirmed by the HRA.
