Reducing Emergency Department Utilization With an After Visit Summary Nudge Toward Alternative Care Options

Behavior, Health Clinical Trial

Official title:

Reducing Emergency Department Utilization With an After Visit Summary Nudge Toward Alternative Care Options

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05787548
• Other study ID #: 2022-0340
• Status: Completed
• Phase: N/A
• Start date: April 3, 2023
• Est. completion date: December 11, 2023

Study information

• Verified date: February 2024
• Source: Geisinger Clinic
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 239841
• Est. completion date: December 11, 2023
• Est. primary completion date: December 11, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Age 18+
• Has a Geisinger Primary Care Physician assigned
• Completes an outpatient office visit or telemedicine appointment at Geisinger

Exclusion Criteria:

• 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

Related Conditions & MeSH terms

• Behavior, Health
• Emergencies

Intervention

Behavioral:
• Contact information
Information on how to contact Geisinger if the patient needs care
• Urgent care map
A map of the patient's nearest Geisinger urgent care location, with information about urgent care
• Self-triage chart
A chart demonstrating what to do in response to several common conditions where the patient might be compelled to visit the ED

Locations

Country	Name	City	State
United States	Geisinger Clinic	Danville	Pennsylvania

Sponsors (1)

Lead Sponsor	Collaborator
Geisinger Clinic

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Urgent care visits	Visited urgent care (y/n)	In the 30 days following the appointment
Other	Calls	Called Geisinger (y/n)	In the 30 days following the appointment
Other	Patient portal messages	Sent a patient portal message (y/n)	In the 30 days following the appointment
Primary	Inappropriate ED visits	Visited the ED inappropriately (y/n); We will apply the NYU algorithm (Ballard et al., 2010) to determine whether an ED visit is inappropriate.	In the 30 days following the appointment