N/A
N=514
Discharge Information and Support for Patients Receiving Outpatient Care in the Emergency Department
Multimorbidity
Bottom Line
View on ClinicalTrials.gov: NCT01717976 ↗Enrolled (actual)
514
Serious AEs
7.6%
Results posted
Jun 2017
Primary outcome: Primary: Number of Participants Experiencing Repeat ED Use — 64; 59 Participants
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- DISPO ED (Behavioral)
- Age
- Pediatric, Adult, Older Adult
- Sex
- All
- Sponsor
- VA Office of Research and Development
- Primary completion
- Mar 2016
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Number of Participants Experiencing Repeat ED Use |
64; 59 | — |
| SECONDARY Number of Participants Satisfied With Health Care |
115; 106 | — |
| SECONDARY Number of Participants Satisfied With Health Care |
115; 106 | — |
| SECONDARY Number of Participants Satisfied With Health Care |
115; 106 | — |
| SECONDARY Total Costs to the VHA |
38273.16; 31696.00 | — |
Summary
The Veterans' Health Administration (VHA) is committed to improving primary care through the implementation of Patient Aligned Care Teams (PACTs). Improving access to services and care coordination are among the primary goals of PACTs; however, there remain many unanswered questions about how best to use the limited time of PACT team members, such as nurse care managers, to accomplish this. This study will evaluate the effectiveness of a nurse-led telephone support program for Veterans who have been treated recently in the emergency department (ED) and are at high risk for repeat visits. The program's goals are to reduce the need for future ED use and improve satisfaction among Veterans by providing information and support related to the ED visit, enhancing chronic disease management and educating Veterans and family members about PACT and other VA and community services. If proven effective, this program could improve health and healthcare for a large, vulnerable group of Veterans and be cost saving for VHA.
Eligibility Criteria
Inclusion Criteria
To be included in the study, patients must meet all of the following:
- Treated and released from the Durham VA ED;
- Receive primary care from a Durham VAMC affiliated primary care clinic (at least one visit in a primary care clinic affiliated with the Durham VAMC within the previous 12 months);
- At least one VAMC ED visit or hospital admission within the 6 months preceding the index visit;
- Diagnosed with 2 or more chronic health conditions; and
- Valid telephone number in the medical record; in the investigators' pilot studies, 98.7% of Veterans had a valid phone number in the medical record.
Exclusion Criteria
Patients will be excluded if they meet any of the following:
- Reside in a nursing home (or other institutional setting);
- Unable to communicate on the telephone, and no proxy available;
- Lacks decision-making capacity, and no proxy available; or
- Returned to ED within 24 hours of discharge from initial visit.
- Have a current Category 1 high-risk suicide flag on their CPRS medical record; or Visit the PEC (Psychiatric Emergency Clinic) within 24 hours of discharge from initial ED visit.
- Enrolled in a study that prohibits cross-enrollment in other studies.
Data sourced from ClinicalTrials.gov (NCT01717976). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.