Reducing Emergency Department Utilization With an After Visit Summary Nudge Toward Alternative Care Options
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 239,841
- 试验地点
- 1
- 主要终点
- Inappropriate ED visits
研究概览
简要总结
Decreasing utilization of the Emergency Department (ED) is a priority for the system. Often, ED visits can be avoided if patients contact Geisinger first to get appropriate direction for their concern or are otherwise better informed about reasons to visit the ED vs. urgent care or primary care facilities. The study team is working to reduce ED utilization by including additional information in adult outpatient After Visit Summaries (AVSs). The study will involve will involve A/B testing different AVS versions, including 1) a version that encourages patients to contact Geisinger via different contact methods, 2) a version that includes a map to the patient's closest ConvenientCare location and accompanying information about ConvenientCare, and 3) a version that includes a self-triage guide. A control group will receive the current standard AVS. Analysis results will be assessed to determine which version is most effective at reducing ED use.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Has a Geisinger Primary Care Physician assigned
- •Completes an outpatient office visit or telemedicine appointment at Geisinger
排除标准
- •The AVS was not printed according to the EHR, and the patient does not have an active MyGeisinger patient portal account, so they do not have a way to view the AVS
研究组 & 干预措施
Standard practice
Patients in this arm will receive the current standard practice AVS.
Contact us first
Patients in this arm will receive the standard AVS, plus information on how to contact Geisinger if they need medical attention.
干预措施: Contact information (Behavioral)
Contact us first + urgent care map
Patients in this arm will receive the standard AVS, plus information on how to contact Geisinger if they need medical attention, plus a map to their nearest Geisinger urgent care location and additional information about urgent care.
干预措施: Contact information (Behavioral)
Contact us first + urgent care map
Patients in this arm will receive the standard AVS, plus information on how to contact Geisinger if they need medical attention, plus a map to their nearest Geisinger urgent care location and additional information about urgent care.
干预措施: Urgent care map (Behavioral)
Contact us first + urgent care map + self-triage
Patients in this arm will receive the standard AVS, plus information on how to contact Geisinger if they need medical attention, plus a map to their nearest Geisinger urgent care location and additional information about urgent care. This arm will also receive a self-triage chart, with common reasons patients go to the ED and situations where seeking alternative care might be appropriate.
干预措施: Contact information (Behavioral)
Contact us first + urgent care map + self-triage
Patients in this arm will receive the standard AVS, plus information on how to contact Geisinger if they need medical attention, plus a map to their nearest Geisinger urgent care location and additional information about urgent care. This arm will also receive a self-triage chart, with common reasons patients go to the ED and situations where seeking alternative care might be appropriate.
干预措施: Urgent care map (Behavioral)
Contact us first + urgent care map + self-triage
Patients in this arm will receive the standard AVS, plus information on how to contact Geisinger if they need medical attention, plus a map to their nearest Geisinger urgent care location and additional information about urgent care. This arm will also receive a self-triage chart, with common reasons patients go to the ED and situations where seeking alternative care might be appropriate.
干预措施: Self-triage chart (Behavioral)
结局指标
主要结局
Inappropriate ED visits
时间窗: In the 30 days following the appointment
Visited the ED inappropriately (y/n) We will apply the NYU algorithm (Ballard et al., 2010) to determine whether an ED visit is inappropriate.
次要结局
未报告次要终点
研究者
Amir Goren
Program Director, Behavioral Insights Team
Geisinger Clinic