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questionnaire (i.e. perception of resource utilization, duplication of test, continuity of care and
satisfaction with knowledge and management of patient).
Patient recruitment in the ED
The Research and Ethics Committee of the SMBD-JGH allowed for patient recruitment to
commence after approving the patient consent and questionnaire forms. Patient enrolment
occurred on weekdays from 8:00am to 10:00pm except on statutory holidays. Two research
assistants conducted patient recruitment between 8:00am and 4:00pm; one research assistant
enrolled patients while the other entered their medical information into the SCS database
(consultation reports, emergency physician comments, follow up plan, discharge medications,
blood test results, maintained the log, telephoned patients). Between 4:00pm and 10:00pm
patient inflow was slower, therefore only one RA was needed for both tasks. After surveying at
what time PCP offices closed, decision was taken not to recruit at night because of the incapacity
of bi-directionality of information transfer.
Every 30 minutes, the application sorted out any new ED visits of patients from the 23 FP
participating in the study and indicated them on a SCS patient list. Research assistants would
subsequently take that list and approach all patients appearing on it. RAs approached patients
only after they had been triaged. The RA would explain the study to the patient and obtain
informed consent. It was also the RA’s responsibility to make sure the application had correctly
identified the patient’s PCP and to verify patient inclusion/exclusion criteria. A patient was
eligible if he/she was ≥ 18 years, spoke either French or English or had a translator and was an
active patient of the family physician identified (had seen their FP at least once within the last 2
years). A Short Portable Mental Status questionnaire (annex H) was also administered on every
candidate approached. If the patient made 5 errors or more, the patient was excluded according
to instructions from the ethics committee of the JGH. Informed consent was required for every
visit to the ED. Patient consent meant agreeing to the electronic transfer and also allowing their
family physician access to their medical information. Patients could also agree to answer a
questionnaire assessing patient satisfaction. The consent forms were designed to give patients
the choice to agree to one and/or both of the above options. The time duration for completion of
patient enrolment was 12 months.
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