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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 they received a diagnosis of an ambulatory sensitive condition (ASC). The evaluation will compare eligible patients with an ASC who were randomly assigned to receive follow-up outreach 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 following the appointment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Nurse Nudge | Experimental | Nurses in CMSL clinics will receive a notification to provide follow-up outreach to patients after the patient receives an ambulatory sensitive diagnosis. |
|
| Control | No Intervention | Nurses in CMSL clinics will receive standard follow-up notifications, which may mean no notifications, after a patient has received an ambulatory sensitive diagnosis. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Nurse Nudge | Behavioral | Nurses will be nudged to call the patients, which may increase the likelihood that the patient receives a post-appointment follow-up call. |
|
| Measure | Description | Time Frame |
|---|---|---|
| ED Visit (yes/no) | Does outreach decrease ED visits? | within 7 days following day of appointment |
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| Measure | Description | Time Frame |
|---|---|---|
| Nurse call to patient | Does the nurse nudge increase post-appointment nurse calls to patients? | Within 7 days post-appointment |
Inclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Geisinger | Danville | Pennsylvania | 17821 | United States |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jan 24, 2025 | Jan 24, 2025 | Prot_SAP_000.pdf |
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