Lehi

Researchers are evaluating the adaptation and implementation of an innovative clinical decision support CDS tool called ePNa, originally validated in emergency departments, for use in urgent care clinics to improve pneumonia diagnosis and treatment. This study aims to combine ePNa with Stanfords CheXED artificial intelligence model to classify chest images quickly and accurately. The goal is to enhance pneumonia care in ambulatory settings where high patient volumes may benefit from updated and efficient diagnostic tools, especially as COVID-19 evolves. The study involves adapting ePNa for use in urgent care clinics by modifying it to work with the more limited patient data available in these settings and incorporating a chest imaging prompt. The combined ePNa-CheXED tool will be piloted among super user clinicians during clinic shifts. One of two clusters of urgent care clinics will receive the adapted tool, while the other will serve as usual care control. Additionally, a physician survey will assess clinicians experiences with ePNa-CheXED six months after implementation. Participants will be patients aged 12 and older diagnosed with pneumonia, confirmed by radiographic imaging. Physicians and advanced practice clinicians in selected urgent care clinics will also participate by completing surveys. The study will monitor outcomes including the accuracy of pneumonia diagnosis, changes in transfer rates to emergency departments, unplanned subsequent ED visits or hospitalizations, and overall healthcare resource use. The study will continue for up to three years, with ongoing evaluation of ePNa use and impact in the urgent care clinical environment.

Researchers are collecting data through a registry to study the outcomes of implantable cardioverter-defibrillators ICDs placed in ambulatory surgical centers for patients with arrhythmia. The main goals are to determine how often serious complications or adverse events occur with both initial and replacement ICD implants and to evaluate the time and cost efficiency for doctors and patients. This registry gathers information at several points during screening, at the time of implant, and two weeks afterward during a wound check. The study focuses on patients receiving ICD devices in outpatient ambulatory surgical centers, without comparison groups or experimental treatments. Participants will have their implantation success assessed at a two-week follow-up. Data collection includes monitoring for complications and efficiency outcomes. The registry runs from August 2017 until August 2028, and participants will undergo routine clinical evaluations associated with their ICD implantation and follow-up care.

This research aims to compare two different approaches to post-hospitalization follow-up care for children hospitalized with common infections such as pneumonia, skin and soft tissue infections, acute gastroenteritis, or urinary tract infections. The study evaluates whether automatic follow-up visits scheduled at discharge or a more flexible as-needed PRN follow-up approach, where parents monitor symptoms and decide on visits, impact hospital readmission rates and other health outcomes. Participants are randomly assigned to one of two groups. One group receives a recommendation for automatic follow-up, instructing them to schedule and attend a follow-up visit regardless of symptom improvement. The other group receives a recommendation for PRN follow-up, where scheduling a visit at discharge is not required, and parents decide if a visit is necessary based on their childs symptoms. Both groups are monitored to compare outcomes over time. During the study, researchers will track hospital readmissions within 14 days of discharge as the primary outcome. Secondary outcomes include medical interventions and the childs health-related quality of life measured seven days after discharge. Additional factors like healthcare use, parent anxiety, satisfaction, and costs will also be assessed. The study includes follow-up through communications with healthcare providers and monitoring of immunizations and well-child visits. Participation lasts at least through the 14-day post-discharge period to capture these outcomes.

Researchers are studying children hospitalized with bronchiolitis to compare two different strategies aimed at improving follow-up care after hospital discharge. The study focuses on increasing the use of as-needed follow-up visits prescribed by hospital physicians and reducing unnecessary routine follow-up visits, which research has shown are often not needed. This trial evaluates how these strategies may impact care and family experience for young children recovering from bronchiolitis. The study compares a moderate-resource implementation strategy with a high-resource implementation strategy. The moderate approach includes educational outreach with materials for families, clinician performance reviews, and clinical decision support tools. The high-resource strategy adds small-group facilitation and expert coach-led support to the components of the moderate strategy. These strategies are designed to encourage appropriate follow-up care decisions by hospitalists. Participants are children diagnosed primarily with bronchiolitis, discharged from general inpatient care outside intensive or emergency settings. Researchers will measure how often as-needed follow-up is prescribed and sustained within seven days after hospital discharge. Families attendance at follow-up visits will be tracked to assess if unnecessary visits decrease. The study will monitor outcomes related to follow-up care practices and their impact through the hospital stay and shortly after discharge, with participation lasting through the immediate post-hospital period.