Lehi

Researchers are evaluating a clinical decision support (CDS) tool called ePNa, originally designed for emergency departments, to improve pneumonia diagnosis and treatment in urgent care clinics in Utah. This study focuses on adapting ePNa for use in urgent care centers (UCCs), where pneumonia patients are frequently seen, and combining it with Stanford's CheXED artificial intelligence model to enhance chest image analysis. The goal is to implement and test this adapted tool to support clinicians in making accurate and timely pneumonia care decisions, especially as diagnostic and treatment methods evolve during the COVID-19 pandemic. The study involves adapting ePNa to fit the data limitations and workflow of urgent care clinics, incorporating AI-based chest image classification that provides results in less than one second. The adapted tool will be piloted with selected "super user" clinicians and then deployed to one of two randomly chosen UCC clusters, while the other cluster continues usual care. The implementation process will follow the CFIR framework for best practices in integrating new clinical tools, including identifying barriers and facilitators through focus groups, interviews, and workflow observation. Participants include pneumonia patients aged 12 years and older with specific diagnostic codes, and clinicians working in the selected urgent care clinics. The study will collect data on pneumonia diagnosis accuracy, patient transfers to emergency departments, and safety outcomes like unplanned hospital visits and mortality within 30 days. Physician surveys will assess user experience with ePNa. The study is planned to last up to three years, with ongoing monitoring of how ePNa impacts urgent care clinical environments.

This research study focuses on patients with arrhythmia who are receiving implantable cardioverter-defibrillators (ICDs) in ambulatory surgical centers (ASCs). The main goal is to evaluate the overall rate of serious complications or adverse events related to both primary implants and replacement devices. Additionally, the study assesses the cost and time efficiency for both physicians and patients involved in the implantation process. Participants will have data collected at three key points: during screening, at the time of the ICD implant procedure, and two weeks after the implant during a wound check. This registry collects information from multiple ambulatory surgical centers to gather comprehensive safety and efficiency data. Throughout the study, participants will be monitored for any serious complications or adverse events following the implant. The primary outcome measured is the success of the implantation assessed at the two-week follow-up. The study aims to provide valuable real-world information on the safety and efficiency of ICD implants performed in outpatient surgical settings.

Researchers are evaluating the best approach to post-hospitalization follow-up care for children hospitalized due to common infections like pneumonia, skin and soft tissue infections, acute gastroenteritis, or urinary tract infections. The study compares automatic follow-up visits, which are routinely scheduled after discharge, against as-needed (PRN) follow-ups where parents monitor symptoms and decide if a visit is necessary. This trial aims to see if the PRN approach is as effective as automatic visits in preventing hospital readmissions and ensuring continuity of care, while also considering the burden of missed work, school, and extra costs for families. Children enrolled in the study are randomly assigned to either receive a recommendation for automatic follow-up visits or a recommendation for PRN follow-up at hospital discharge. The automatic group is instructed to schedule and attend a follow-up visit regardless of symptom improvement, whereas the PRN group is advised that follow-up visits are not required unless symptoms warrant it. The study involves a total of 2,674 children, with half in each group, to compare the outcomes of these two follow-up strategies. Participants and their families will be monitored for hospital readmission within 14 days after discharge, which is the primary outcome. Researchers will also assess additional medical interventions, child quality of life, symptom duration, healthcare use, parent anxiety and confidence, satisfaction with care, and communications with medical providers. Safety outcomes such as medical errors and infection-related readmissions will be tracked. The study includes assessments of time and cost burdens on parents and children, and will gather extensive information through questionnaires and medical records during the follow-up period.

Researchers are studying children aged 0 to 2 years who have been hospitalized for bronchiolitis, a common lung infection. The study compares two different strategies designed to improve how doctors prescribe follow-up care that families can use as needed after hospital discharge. This is important because many automatic follow-up visits may not be necessary, and the study aims to reduce unnecessary visits while supporting families' preferences. The study tests two approaches: a moderate-resource strategy and a high-resource strategy. The moderate approach provides education for doctors and families, review of doctors' performance, and materials to help with clinical decisions. The high-resource strategy includes all these components plus additional small-group sessions and expert coaching to support doctors in follow-up care decisions. Participants will be monitored to see how well these strategies increase as-needed follow-up prescriptions within 7 days after leaving the hospital. Families and doctors will be supported with educational and decision-making materials. The study focuses on improving care after hospital discharge while minimizing unnecessary clinic visits, aiming for better, more personalized follow-up care for children with bronchiolitis.