Stories to Educate Patients With Ankle, Foot, and Knee Injuries

Study Overview
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Brief Summary
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Study will test the use of narratives on patient satisfaction and translation of an evidence-based approach to the use of X-rays for leg injuries in the Emergency Department (ED). The investigators will identify patients with foot, ankle, or knee injuries for whom X-rays are determined to not be needed. On discharge, patients will receive the current fact-based sheet or that plus a narrative explaining the work-up and treatment of these injuries. Outcomes will be assessed by a survey measuring patient satisfaction and understanding.

Official Title
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Comparative Effectiveness of Descriptive Versus Narrative Emergency Department Discharge Instructions for Patient Education on Unnecessary Testing for Ankle, Foot and Knee Injuries

Conditions
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Injury

Intervention / Treatment
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* Behavioral: Narrative
* Behavioral: Control


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Acute traumatic knee, ankle or foot injury presenting to ED No indication for X-ray by Ottawa Rules criteria ED provider planning to discharge patient Exclusion Criteria: X-ray obtained Need for X-ray by established Ottawa Rules criteria Children Pregnant women Patient to be admitted to the hospital Patient non-English speaking or illiterate

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Narrative<br>This arm will receive information regarding leg injuries and X-ray usage in narrative form in addition to standard of care discharge information. | Behavioral: Narrative<br>* Narrative form as described above.<br>|
| Placebo Comparator: Control<br>This arm will receive a blank piece of paper in addition to the standard of care discharge information. | Behavioral: Control<br>* Blank piece of paper<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient Satisfaction | To measure patient satisfaction, we will use a validated survey instrument. The survey asks patients 5 questions, which they answer by providing responses on a 5-point scale ranging from Poor to Excellent. The questions include: My satisfaction with the amount of time spent with me by the person who evaluated and treated me was.... The explanation I received of how my illness should be treated was... The way the health care provider treated me was... My overall satisfaction with my visit was... Your care provider determined that you did not need an X-ray for your injury. What is your level of satisfaction with that decision? | 5 minutes after intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Acute, lower, extremity, not requiring, diagnostic, imaging