Opportunities in Outpatient Care

Characterizing and Quantifying Challenges and Opportunities in Outpatient Care

The purpose of this research study is to determine whether there are things that Intermountain can do to break down barriers to helping patients see their primary doctors or other outpatient clinics. To do this we will develop and test a classification scheme to help us understand how we might reduce some avoidable emergency department and InstaCare visits.

Study Overview

• Status: Completed
• Conditions: Outpatient Care

Detailed Description

The study will develop a first-pass taxonomy that classifies the causes and effects of challenges and opportunities of outpatient care leading to potentially avoidable ED and urgent care center visits.

The study will quantify the proportion of ED and urgent care center visits that result from a challenge or opportunity in outpatient care and classify the causes and outcomes according to the taxonomy. It will also define the 30 and 90 day episode costs of ED and urgent care center visits associated with a challenges and opportunities of outpatient care beginning the day of the ED or urgent care center visit.

• Study Type: Observational
• Enrollment (Actual): 1027

Contacts and Locations

Study Locations

• United States
  • Utah
    • Murray, Utah, United States, 84157
      • Intermountain Medical Center
    • Murray, Utah, United States, 84107
      • Cottonwood InstaCare
    • Riverton, Utah, United States, 84065
      • Riverton Hospital
    • Riverton, Utah, United States, 84065
      • Southridge InstaCare
    • Salt Lake City, Utah, United States, 84143
      • LDS Hospital
    • Salt Lake City, Utah, United States, 84102
      • Salt Lake City InstaCare
    • Salt Lake City, Utah, United States, 84105
      • Memorial InstaCare
    • Sandy, Utah, United States, 84094
      • Alta View Hospital
    • Sandy, Utah, United States, 84070
      • Sandy InstaCare

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 7 years and older (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Emergency Department/InstaCare patients

Description

Inclusion Criteria:

• All Emergency Department/IC patients who can consent, including children.

Exclusion Criteria:

• Unable to give consent
• Prisoners

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Incidence rate of avoidable ED visits due to a "missed" opportunity in outpatient care	The proportion of ED visits during the selected shifts that were deemed to be potentially avoidable according to the developed taxonomy	1 Day
Incidence rate of avoidable InstaCare visits due to a "missed" opportunity in outpatient care	The proportion of Instacare visits during the selected shifts that were deemed to be potentially avoidable according to the developed taxonomy	1 Day

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Patient Disposition Status from the ED	Disposition status from after the ED visit, collected from the medical record. Status will be one of the following: admitted, observation, transfer to facility, discharged, deceased.	1 Day
Patient Disposition Status from the InstaCare	Disposition status from after the Instacare visit, collected from the medical record. Status may be admitted, observation, transfer to facility, discharged, or deceased.	1 Day
Length of stay for admitted patients	Length in stay by days in study patients admitted to the hospital	Up to 30 days
Harms to patients due to the missed opportunities in outpatient care.	Categorization of the "harms" on patients due to the missed opportunities in outpatient care using NCC-MERP categorizations	90 days
30 day episode costs	All attributable healthcare costs accrued to study patients from the date of visit to +30 days.	30 days
90 day episode costs	All attributable healthcare costs accrued to study patients from the date of visit to +90 days.	90 days

Collaborators and Investigators

• Sponsor: Intermountain Health Care, Inc.
• Investigators: Principal Investigator: Todd Allen, MD, Intermountain Health Care, Inc.

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2017
• Primary Completion (Actual): October 31, 2017
• Study Completion (Actual): October 31, 2017

Study Registration Dates

• First Submitted: May 17, 2017
• First Submitted That Met QC Criteria: May 19, 2017
• First Posted (Actual): May 22, 2017

Study Record Updates

• Last Update Posted (Actual): August 14, 2018
• Last Update Submitted That Met QC Criteria: August 10, 2018
• Last Verified: August 1, 2018

More Information

Terms related to this study

• Keywords: emergency department visits; outpatient care
• Other Study ID Numbers: 1050460

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No