Trial of Emergency Department Discharge With Enhanced Transitions of Care Compared to Usual Care

Randomized Control Trial of Emergency Department Discharge With Enhanced Transitions of Care Compared to Usual Care

This is a randomized controlled trial to assess the relative effectiveness of providing Enhanced Transitions of Care (ETOC) to improve patient outcomes after discharge from the Emergency Department (ED). Patients who are being discharged from the ED and have had a previous ED visit or hospital admission within the Thomas Jefferson Hospital System (TJUH or Methodist) within the past 90 days will be eligible for enrollment in this trial. Patients who consent to enrollment will be randomized to discharge by usual care or discharge with ETOC as provided by the company BoardRounds.

Inclusion Criteria:

• Adult (18 yrs and older) patients
• Have had a previous ED visit or hospital admission in the 90 days prior to the current ED visit (at Thomas Jefferson University Hospital or Methodist Hospital)
• Have just completed evaluation in the Thomas Jefferson University Hospital Emergency Department for any problem,
• Are ready for discharge from the Thomas Jefferson University Hospital ED, and
• Provide informed consent

Exclusion Criteria:

• Non-English speaking patients
• Patients undergoing medical clearance for a detox center or any involuntary court or magistrate order
• Patients who live outside Philadelphia area (unable to seek follow-up care in Philadelphia) or other condition known to preclude follow-up (such as no reliable access to a telephone)
• Patients in police custody or currently incarcerated individuals
• Patients who have, in their clinician's best judgment, major communication barriers such as visual or hearing impairment or dementia that would compromise their ability to give written informed consent