Physician Engagement in EMS Transport Refusal Rates
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: Physician Consultation, Standard of Care.
- Who it may be relevant to
- Registry conditions: Refusal of Transport. Basic parameters: from 18 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 →
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Official title
The Role of Direct Physician Engagement in EMS Transport Refusal Rates: A Prospective Study
Overview
The primary goal of this study is to find out if patients who speak with an EMS physician over the phone are less likely to refuse care compare to patients who do not speak with an EMS physician.
Detailed description
This study aims to assess the impact of direct physician communication on patients' decisions to refuse EMS transport. The research approach is designed to measure the influence of physician interaction on patient transport decisions in a prospective model. By conducting this research, the study team hopes to provide evidence-based recommendations for EMS protocols regarding patient engagement and refusal management.
Interventions
- Behavioral Physician Consultation
Every other month will be randomized to either Physician Consultation or Standard of Care. During the months designated for Physician Consultation, direct communication between the patient and a designated physician by phone will be implemented when a patient refuses transport in cases where the EMS clinician feels that physician consultation is warranted for further guidance. The physician will attempt to address patient concerns and provide additional medical advice. - Behavioral Standard of Care
Every other month will be randomized to either Physician Consultation or Standard of Care. During the months designated for Standard of Care, physician intervention will not be provided. For safety reasons, if physicians or EMS MEDIC clinicians feel that speaking with the patient is important to provide additional clinical benefit, they may do so without hesitation and can override the designated intervention month.
Primary outcome measures
- Number of Patients Transported [Time frame: Day 1]
Secondary outcome measures (4)
- Number of Patients Admitted to Hospital [Time frame: Day 1]
- Number of Patients Discharged from Emergency Department [Time frame: Day 1]
- Duration of EMS Interaction [Time frame: Day 1]
- Number of EMS Same-Day Return [Time frame: Hour 24 Post Initial Call]
Eligibility criteria
Inclusion criteria
- Adult patients ≥18 years old in care of Mecklenburg EMS (MEDIC) on an emergency basis (911 call) who wish to refuse transportation to the hospital in whom MEDIC has, via existing processes and decision-making, engaged online medical control EMS Physicians for further guidance
Exclusion criteria
- Patients <18 years old.
- Patient refuses to speak with online medical control EMS Physicians. MEDIC or patient requests to have primary care physician.
- Lack of clinical capacity.
- Incarcerated population.
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
- Supportive care
Study locations
United States · 1 center
- Atrium Health Carolinas Medical Center — Charlotte
Identifiers
NCT: NCT07107737 · IRB00134848