Opportunities in Outpatient Care

Completed

• Conditions: Outpatient Care

• Registration Number: NCT03163225
• Lead Sponsor: Intermountain Health Care, Inc.

Brief Summary

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

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.

Study Timeline

• Study First Submitted: 2017-05-17
• Study First Submitted QC: 2017-05-19
• Study First Posted: 2017-05-22
• Study Start: 2017-09-01
• Primary Completion: 2017-10-31
• Study Completion: 2017-10-31
• Status Verified: 2018-08
• Last Update Submitted: 2018-08-10
• Last Update Posted: 2018-08-14

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 1027

Inclusion Criteria

• All Emergency Department/IC patients who can consent, including children.

Exclusion Criteria

• Unable to give consent
• Prisoners

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Incidence rate of avoidable ED visits due to a "missed" opportunity in outpatient care	1 Day	The proportion of ED visits during the selected shifts that were deemed to be potentially avoidable according to the developed taxonomy
Incidence rate of avoidable InstaCare visits due to a "missed" opportunity in outpatient care	1 Day	The proportion of Instacare visits during the selected shifts that were deemed to be potentially avoidable according to the developed taxonomy

Secondary Outcome Measures

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

Trial Locations

Locations (9)

Cottonwood InstaCare; 🇺🇸 Murray, Utah, United States

Riverton Hospital; 🇺🇸 Riverton, Utah, United States

Southridge InstaCare; 🇺🇸 Riverton, Utah, United States

Intermountain Medical Center; 🇺🇸 Murray, Utah, United States

Salt Lake City InstaCare; 🇺🇸 Salt Lake City, Utah, United States

Memorial InstaCare; 🇺🇸 Salt Lake City, Utah, United States

Sandy InstaCare; 🇺🇸 Sandy, Utah, United States

LDS Hospital; 🇺🇸 Salt Lake City, Utah, United States

Alta View Hospital; 🇺🇸 Sandy, Utah, United States