Quasi-Randomized Evaluation of the UCLA Next Day Clinic (NDC) (NDC)

May 13, 2026 updated by: Richard K. Leuchter, MD, University of California, Los Angeles
The Next Day Clinic (NDC) is a quality improvement initiative that will be launched and operated by UCLA Health starting July 22, 2024. Its goals are to improve patient care and safety and to maximize cost effectiveness. The way it does this is by identifying patients in the ED who would normally be admitted for low-acuity conditions, and diverting them to a high-acuity clinic the following day called the NDC. This will help decompress the ED and the hospital, and allow for overall higher quality care. The Health System has partnered with UCLA's Healthcare Value Analytics and Solutions [UVAS] group which specializes in these types of program evaluations. The analysis conducted by the study team will be used to directly inform NDC operations, scaling, and future plans.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

NDC is a hospital avoidance model with the potential to simultaneously improve the quality and safety of acute care, reduce costs, and address hospital/ED overcrowding. This novel hospital avoidance program will divert patients from the ED who have been diagnosed with the following conditions and meet certain clinical criteria:

  • Diabetic Foot Infection/Osteomyelitis
  • Cellulitis
  • Congestive Heart Failure
  • Syncope
  • Pyelonephritis/Urinary Tract Infection
  • Pneumonia
  • Acute Kidney Infection

Study Type

Interventional

Enrollment (Actual)

570

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • California
      • Los Angeles, California, United States, 90024
        • Ronald Reagan UCLA Medical Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • 18 years of age or older
  • About to be admitted through the ED for one of the NDC diagnoses or a synonym (per Study Protocol document), defined by the presence of a Plan to Admit order or Bed Request order, OR recently admitted under observation or inpatient status for one of the NDC diagnoses.
  • Identified as at-risk for an avoidable hospitalization in the ED based on a pre-determined set of lab and vital parameters.
  • Insurance that authorizes the patient to follow-up at UCLA Health, or self-pay
  • Admitted or being admitted to an internal medicine service

Exclusion Criteria:

  • Heart or lung transplant recipient with concern for graft dysfunction
  • Pregnant
  • Enrolled in hospice
  • Admitted to a critical care service
  • ED deems discharge unsafe due to complex social or medical factors
  • Active malignant cancer (per Council of State and Territorial Epidemiologists value set)
  • Pulmonary arterial hypertension (per Joint Commission value set)
  • Undergoing workup for solid organ transplant
  • Interstitial lung disease (including pulmonary fibrosis) (per Higher Level 7 value set)
  • Requiring inpatient procedure or surgery defined by the presence of an anesthesia event or operating room encounter.
  • The ED deems discharge unsafe due to complex social or medical factors.
  • Transferred to an ineligible hospital

Note:

The Health System plans to limit the volume of referrals to the NDC by only referring patients who have an even birth date (this is more equitable than first-come-first-serve, because wage workers are more likely to come to the ED later in the day; even/odd birth date theoretically keeps more spots open for patients presenting to the ED later).

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: ED-initiated hospitalization
Patients with odd birthdays will be routed to standard-of-care ED-initiated hospitalization pathways.
Experimental: Next Day Clinic
Patients with even birthdays who meet inclusion criteria will be given the option to receive care in the Next Day Clinic to avoid hospitalization.
Other: Next Day Clinic
A dedicated Next Day Clinic team consisting of a clinician and nurse case manager will provide care and specialist referrals to patients within 24 hours of an ED visit that would have resulted in hospitalization without this novel hospital avoidance initiative.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Days alive and out of hospital (DAOH)
Time Frame: 30 days from index ED visit
Cumulative number of days alive and not admitted or boarding in a hospital or emergency department
30 days from index ED visit

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Financial analysis
Time Frame: Through study completion, an average of 12 months
Total cost per day of treatment
Through study completion, an average of 12 months
Cost effectiveness analysis
Time Frame: Through study completion, an average of 12 months
Total cost per day alive and out of hospital
Through study completion, an average of 12 months
Global health-related quality of life
Time Frame: 30 days from index ED visit
Composite PROMIS-29+2 score (patient reported outcome measurement information system). PROMIS stands for Patient-Reported Outcomes Measurement Information System. High scores mean more of the concept being measured.
30 days from index ED visit
Patient experience
Time Frame: 30 days from index ED visit
Measured by PSQ-18 (patient satisfaction questionnaire). PSQ stands for Patient Satisfaction Questionnaire. High scores indicate higher levels of satisfaction.
30 days from index ED visit
Hospitalizations avoided
Time Frame: Through study completion, an average of 12 months
Each NDC referral with a preceding Plan to Admit order or Bed Request order (regardless of treatment arm) will be considered an avoided hospitalization, given that the presence of one of these orders establishes that the counterfactual for NDC treatment in hospitalization.
Through study completion, an average of 12 months
Hospital bed-days saved
Time Frame: Through study completion, an average of 12 months
For each referral to the NDC, the number of hospital bed-days saved will be established by using the mean length of stay for patients treated per-protocol in the control condition matched for the same presenting illness.
Through study completion, an average of 12 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of California, Los Angeles

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

July 22, 2024

Primary Completion (Actual)

January 20, 2026

Study Completion (Actual)

March 31, 2026

Study Registration Dates

First Submitted

July 17, 2024

First Submitted That Met QC Criteria

July 24, 2024

First Posted (Actual)

July 30, 2024

Study Record Updates

Last Update Posted (Actual)

May 18, 2026

Last Update Submitted That Met QC Criteria

May 13, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 24-000913

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

De-identified data may be uploaded to a data repository system such as Vivli.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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