Nurse Follow-up to Reduce Inappropriate Emergency Department Use in Adult Patients with Ambulatory Sensitive Conditions in CMSL Study 2

What this Trial Is About

This research aims to evaluate a nurse-led intervention designed to reduce unnecessary emergency department visits among adult patients diagnosed with ambulatory sensitive conditions (ASCs) at Geisinger's Community Medicine Service Line (CMSL) clinics. The study will compare patients who receive follow-up outreach from nurses after an ASC diagnosis with those who receive standard care. The purpose is to assess if nurse contact via calls or patient portal messages affects emergency department use within seven days after the appointment. Participants will be randomly assigned to one of two groups. In the experimental group, nurses are prompted through the electronic health record system to provide follow-up outreach by phone calls and/or patient portal messages after the patient's appointment. The control group receives usual care, which may include no additional follow-up notifications. The study includes patients aged 30 and older and will continue until at least 4,330 patients are enrolled in each of three age groups: 30-45, 45-64, and 65 and older. During the study, researchers will monitor emergency department visits within one week after the appointment as the main outcome. The study uses an intent-to-treat analysis and will analyze results separately for each age group and combined. Participation involves receiving usual care or nurse outreach, with data collected through the electronic health record system. The study may also include interim data reviews and could end early based on clinical guidance. The total planned enrollment is approximately 12,990 patients.

CMSL Ambulatory Sensitive Condition Nudge Study 2