CMSL Ambulatory Sensitive Condition Nudge Study 2
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Nurse Nudge.
- Who it may be relevant to
- Registry conditions: Behavioral Intervention, Emergency Department Visits, Nurse Care Coordination. Basic parameters: from 30 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- United States
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Official title
Nurse Follow-up to Reduce Inappropriate Emergency Department Utilization in Adult Patients Seen for Ambulatory Sensitive Conditions in CMSL Study 2
Overview
The project aims to evaluate a nurse-led intervention to reduce inappropriate emergency department (ED) use among adult patients seen at Geisinger's Community Medicine Service Line (CMSL) clinics. The intervention occurs immediately following an appointment where a patient receives a diagnosis of an ambulatory sensitive condition (ASC; i.e., a condition considered to be a risk factor for near-term ED use). The evaluation will compare eligible patients with an ASC who were randomly assigned to receive follow-up outreach (patient portal message and/or call) from a nurse (who was automatically prompted via the Epic electronic health record system to initiate outreach) with those who were randomly assigned to receive standard care. Analyses will be intent-to-treat. The primary outcome is ED use in the week (i.e., 7 days) following the appointment. We ran an earlier version of this intervention (NCT06798389). The current study is modified based on results and clinical guidance. Specifically, more conditions will be included as qualifying ASCs for enrollment. Patients under 30 will be excluded. And rather than calling all patients as in the original study, patient portal users may be contacted via the portal instead of or in addition to a phone call. Finally, in the first study, the intervention was differentially effective by age group (\<45, 45-64, 65+). Our primary analysis will be conducted separately by age group, though we will also conduct an analysis combining across age groups. We will run the study until we reach at least 4,330 patients in each of the following age groups: patients aged 30-45, patients aged 45-64, patients aged 65+. Therefore, our estimated sample size is at least 4,330x3 = 12,990. We may be required to do an interim data pull and/or stop the study early at the direction of clinical or operational leaders.
Interventions
- Behavioral Nurse Nudge
Nurses will be nudged to contact patients, which may increase the likelihood that the patient receives a post- appointment follow-up call and/or portal message.
Primary outcome measures
- ED Visit (yes/no) [Time frame: within 7 days post-appointment]
Eligibility criteria
Inclusion criteria
- Age 30 years +
- Has a qualifying visit in CMSL with an ambulatory sensitive condition (ASC) encounter diagnosis
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Open label
- Primary purpose
- Health services research
Study locations
United States · 1 center
- Geisinger — Danville
Identifiers
NCT: NCT07028398 · 2023-1716-2