Electronic Support for Pulmonary Embolism Emergency Disposition
- Conditions
- Pulmonary Embolism
- Interventions
- Other: Integration of electronic clinical decision support
- Registration Number
- NCT03601676
- Lead Sponsor
- Kaiser Permanente
- Brief Summary
To evaluate the impact of an integrated electronic clinical decision support system to facilitate risk stratification and site-of-care decision-making for patients with acute pulmonary embolism.
- Detailed Description
Many low-risk emergency department patients with acute pulmonary embolism are routinely hospitalized despite being eligible for outpatient care. One impediment to home discharge is the difficulty of identifying which patients can safely forego hospitalization. This pragmatic clinical trial intends to evaluate the effect on emergency department disposition of a multicomponent intervention, including electronic clinical decision support system access, physician education, and physician-specific audit and feedback. The hypothesis for this study is that intervention sites, when compared with concurrent control sites, will see an increase in home discharges without an increase in 5-day pulmonary embolism-related return visits or 30-day all-cause mortality.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 1703
- Acute objectively-confirmed pulmonary embolism, diagnosed in the emergency department
- Comfort-care only
- Left the ED against medical advice
- Current PE radiologically diagnosed >12 hrs prior to arrival
- Recent DVT or PE diagnosed within 30 days
- Pregnant
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Intervention Integration of electronic clinical decision support -
- Primary Outcome Measures
Name Time Method Rate of home discharge from the emergency department following treatment for pulmonary embolism 8 months post-implementation compared to 8 months pre-implementation
- Secondary Outcome Measures
Name Time Method Number of participants with major hemorrhage, recurrent venous thromboembolism, and all-cause mortality 30 days Number of participants with return visits for pulmonary embolism-related signs, symptoms, or interventions 5 days
Trial Locations
- Locations (14)
Kaiser Permanente Fremont Emergency Department
🇺🇸Fremont, California, United States
Kaiser Permanente Oakland Emergency Department
🇺🇸Oakland, California, United States
Kaiser Permanente Richmond Emergency Department
🇺🇸Richmond, California, United States
Kaiser Permanente Redwood City Emergency Department
🇺🇸Redwood City, California, United States
Kaiser Permanente Roseville Emergency Department
🇺🇸Roseville, California, United States
Kaiser Permanente South Sacramento Emergency Department
🇺🇸Sacramento, California, United States
Kaiser Permanente Sacramento Emergency Department
🇺🇸Sacramento, California, United States
Kaiser Permanente San Jose Emergency Department
🇺🇸San Jose, California, United States
Kaiser Permanente San Francisco Emergency Department
🇺🇸San Francisco, California, United States
Kaiser Permanente San Leandro Emergency Department
🇺🇸San Leandro, California, United States
Kaiser Permanente San Rafael Emergency Department
🇺🇸San Rafael, California, United States
Kaiser Permanente Santa Clara Emergency Department
🇺🇸Santa Clara, California, United States
Kaiser Permanente South San Francisco Emergency Department
🇺🇸South San Francisco, California, United States
Kaiser Permanente Santa Rosa Emergency Department
🇺🇸Santa Rosa, California, United States