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

ISRCTN	ISRCTN76703125
DOI	https://doi.org/10.1186/ISRCTN76703125
Protocol serial number	N/A
Sponsor	Kantonsspital Aarau (Switzerland)
Funders	Kantonsspital Aarau (Swizterland) - investigator-driven, Canton AargauHealth Department (Gesundheitsdepartement des Kantons Aargau) - local government grant

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

Primary study design	Observational
Study design	Observational quality-control analysis of current practice
Secondary study design	Other
Study type	Participant 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(s)	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
Key secondary outcome measure(s)	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
Completion date	31/10/2010

Eligibility

Participant type(s)	Patient
Age group	Adult
Lower age limit	18 Years
Sex	All
Target sample size at registration	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

Results and Publications

Individual participant data (IPD) Intention to share	No
IPD sharing plan summary	Not provided at time of registration
IPD sharing plan

Study outputs

Output type	Details	Date created	Date added	Peer reviewed?	Patient-facing?
Participant information sheet	Participant information sheet	11/11/2025	11/11/2025	No	Yes