Opportunities in Outpatient Care

Study Overview
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Brief Summary
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The purpose of this research study is to determine whether there are things that Intermountain can do to break down barriers to helping patients see their primary doctors or other outpatient clinics. To do this we will develop and test a classification scheme to help us understand how we might reduce some avoidable emergency department and InstaCare visits.

Detailed Description
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The study will develop a first-pass taxonomy that classifies the causes and effects of challenges and opportunities of outpatient care leading to potentially avoidable ED and urgent care center visits. The study will quantify the proportion of ED and urgent care center visits that result from a challenge or opportunity in outpatient care and classify the causes and outcomes according to the taxonomy. It will also define the 30 and 90 day episode costs of ED and urgent care center visits associated with a challenges and opportunities of outpatient care beginning the day of the ED or urgent care center visit.

Official Title
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Characterizing and Quantifying Challenges and Opportunities in Outpatient Care

Conditions
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Outpatient Care

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All Emergency Department/IC patients who can consent, including children. Exclusion Criteria: Unable to give consent Prisoners

Ages Eligible for Study
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Minimum Age: 7 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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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence rate of avoidable ED visits due to a missed opportunity in outpatient care | The proportion of ED visits during the selected shifts that were deemed to be potentially avoidable according to the developed taxonomy | 1 Day | 
| Incidence rate of avoidable InstaCare visits due to a missed opportunity in outpatient care | The proportion of Instacare visits during the selected shifts that were deemed to be potentially avoidable according to the developed taxonomy | 1 Day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient Disposition Status from the ED | Disposition status from after the ED visit, collected from the medical record. Status will be one of the following: admitted, observation, transfer to facility, discharged, deceased. | 1 Day | 
| Patient Disposition Status from the InstaCare | Disposition status from after the Instacare visit, collected from the medical record. Status may be admitted, observation, transfer to facility, discharged, or deceased. | 1 Day | 
| Length of stay for admitted patients | Length in stay by days in study patients admitted to the hospital | Up to 30 days | 
| Harms to patients due to the missed opportunities in outpatient care. | Categorization of the harms on patients due to the missed opportunities in outpatient care using NCC-MERP categorizations | 90 days | 
| 30 day episode costs | All attributable healthcare costs accrued to study patients from the date of visit to +30 days. | 30 days | 
| 90 day episode costs | All attributable healthcare costs accrued to study patients from the date of visit to +90 days. | 90 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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outpatient care, emergency department visits