Targeted EHR-based Communication of Diagnostic Uncertainty in the ED
Targeted EHR-based Communication of Diagnostic Uncertainty (TECU) in the ED: An Effectiveness Implementation Trial
Thomas Jefferson University
300 participants
Nov 5, 2024
INTERVENTIONAL
Conditions
Summary
The goal of the clinical trial is to evaluate the preliminary effectiveness and the implementation feasibility of the Targeted EHR-based Communication about Uncertainty (TECU) strategy in improving the quality of care transitions from the emergency department (ED) to home. The overall specific aims related to the trial are to test the preliminary effectiveness of TECU compared to standard of care in reducing patient uncertainty and return ED visits and evaluate the adoption of TECU, exploring patient and clinician barriers and facilitators to TECU implementation.
Eligibility
Inclusion Criteria6
- age 18 years or older
- English language speaking
- assigned a symptom-based diagnosis in the EHR clinical impression
- planned for discharge from the ED during the enrollment visit
- able to complete follow up assessments in 2 and 30 days
- TECU best practice advisory (BPA) electronic health record alert activates during their discharge process
Exclusion Criteria6
- under the age of 18 years
- non-English speaking
- clinically unstable, psychologically impaired or intoxicated, or otherwise unable to provide informed consent as judged by research staff member
- admitted to hospital
- unable to complete follow up in 2 and 30 days
- previously enrolled in this study (during a prior ED visit)
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Interventions
The Targeted EHR-based Communication about Uncertainty (TECU) strategy will be activated in the electronic health record (Epic) every time an ED clinician enters an uncertain diagnosis for a patient being discharged, and will notify the clinician to counsel the patient about uncertainty while additionally triggering automated 1) insertion and printing of the patient handout and 2) provision of a hyperlink for the clinician-facing checklist to guide the discharge conversation.
Locations(1)
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NCT06638021