CMSL Ambulatory Sensitive Condition Nudge Study 2

Part of paid clinical trials in Danville, Pennsylvania.

Sponsor
Geisinger Clinic
Study ID
NCT07028398
Status
Recruiting
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Conditions

  • Behavioral Intervention
  • Emergency Department Visits
  • Nurse Care Coordination

Eligibility Criteria

Sex
ALL
Age
30 Years - N/A
Healthy Volunteers
Not accepted

Interventions

  • Nurse Nudge — BEHAVIORAL
    Nurses will be nudged to contact patients, which may increase the likelihood that the patient receives a post- appointment follow-up call and/or portal message.

Study Details

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 a patient receives a diagnosis of an ambulatory sensitive condition (ASC; i.e., a condition considered to be a risk factor for near-term ED use). The evaluation will compare eligible patients with an ASC who were randomly assigned to receive follow-up outreach (patient portal message and/or call) 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 (i.e., 7 days) following the appointment. We ran an earlier version of this intervention (NCT06798389). The current study is modified based on results and clinical guidance. Specifically, more conditions will be included as qualifying ASCs for enrollment. Patients under 30 will be excluded. And rather than calling all patients as in the original study, patient portal users may be contacted via the portal instead of or in addition to a phone call. Finally, in the first study, the intervention was differentially effective by age group (\<45, 45-64, 65+). Our primary analysis will be conducted separately by age group, though we will also conduct an analysis combining across age groups. We will run the study until we reach at least 4,330 patients in each of the following age groups: patients aged 30-45, patients aged 45-64, patients aged 65+. Therefore, our estimated sample size is at least 4,330x3 = 12,990. We may be required to do an interim data pull and/or stop the study early at the direction of clinical or operational leaders.

Key Dates

Start date
May 29, 2025
Status verified
Feb 2026
Primary completion
Jul 31, 2026
Completion
Jul 31, 2026

Study Design

Enrollment
12,990 participants (estimated)
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH

Arms

  • Experimental: Nurse Nudge
    Nurses in CMSL clinics will receive a notification to provide follow-up outreach (calls and/or patient portal messages) to patients after the patient receives an ambulatory sensitive diagnosis.
  • No Intervention: Control
    Nurses in CMSL clinics will receive standard follow- up notifications, which may mean no notifications, after a patient has received an ambulatory sensitive diagnosis.

Primary Outcome Measure

ED Visit (yes/no) [ Time Frame: within 7 days post-appointment ]

Central Contacts

Locations (1)

FacilityCityStateZIPSite coordinators
GeisingerDanvillePennsylvania17821
Amir Goren, PhD

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