Clinical trial NCT06535347: Nudging High-acuity Emergency Department Patients to Schedule a Follow-up Visit
Official title: Nudging High-acuity Emergency Department Patients to Schedule a Follow-up Visit With a Primary Care Provider or Specialist Following Discharge to Decrease Emergency Department Utilization
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Emergency Service, Hospital
Lead sponsor: Geisinger Clinic
Sponsor class: OTHER
First posted: 2024-08-02
Enrollment: 6814
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: The goal of this campaign is to reduce unnecessary emergency department (ED) visits by encouraging patients with high acuity visits to follow up with an appropriate primary care provider (PCP) or specialist and therefore obtain appropriate care outside of the ED. In this campaign, patients will be assigned to receive or not receive outreach following ED discharge that is aligned with the goal. Outreach will occur via a text message and information added to the patient's after visit summary, and will include a contact number to schedule and hyperlink to allow self-scheduling. The study will assess whether ED use differs across patients in different outreach conditions. It will also examine whether patients followed through on the calls to action in the messages differently across conditions.

Detailed description: Enrollment will conclude when either 7500 participants have been enrolled or after 120 days, whichever occurs first.

Eligibility criteria: Inclusion Criteria:

* \>= 18 years of age
* ED visit rated as high acuity (level L2 or L3)
* Discharged from ED in past 24 hours
* Attributed to a Geisinger PCP in Community Medicine Service Line

Exclusion Criteria:

* Have an appointment scheduled within 7 days following discharge with a primary care provider or specialist
* Institutionalized
* Cannot be contacted via the communication modality being used in the study (i.e., SMS), due to insufficient/missing contact information in the electronic health record or because the patient opted out
* Admitted to hospital
* Eloped from ED
* Left ED without being seen
* Deceased prior to messaging

Primary outcomes:
measure: Return to ED
timeFrame: within 120 days following day of discharge
Secondary outcomes:
Other outcomes:
measure: PCP/specialist appointment made
timeFrame: within 7 days following day of discharge
measure: PCP/specialist appointment made
timeFrame: within 14 days following day of discharge
measure: PCP/specialist appointment made
timeFrame: within 30 days following day of discharge
measure: PCP/specialist appointment made
timeFrame: within 60 days following day of discharge
measure: PCP/specialist appointment attended
timeFrame: within 7 days following day of discharge
measure: PCP/specialist appointment attended
timeFrame: within 14 days following day of discharge
measure: PCP/specialist appointment attended
timeFrame: within 30 days following day of discharge
measure: PCP/specialist appointment attended
timeFrame: within 60 days following day of discharge
Locations:
city: Danville
country: United States
facility: Geisinger Health System
state: Pennsylvania
Study officials:
affiliation: Geisinger Clinic
name: Amir Goren, PhD
role: PRINCIPAL_INVESTIGATOR
References: