Pulmonary Embolism
Conditions
Keywords
Emergency Department
Brief summary
This study is a quality improvement project to evaluate health care management of pulmonary embolism (PE) patients. The researchers are testing an intervention to determine if it prevents unnecessary hospital admissions.
Detailed description
The study team anticipates that there will be 5800 acute PE patients over multiple sites. The study team is not recruiting additional sites into the study but tracking of acute PE patients continues.
Interventions
BEHAVIORALPulmonary Embolism (PE) Care in Emergency Department (ED)
Utilize implementation mapping to facilitate intervention development and evaluation that can be disseminated broadly in diverse settings. Intervention to include a structured education program for clinicians on home management of patients with low-risk PE led by regional/national leaders, the development of Clinician pre-commitment, point-of-care nudge including a clinical guideline integrated into an electronic health record clinical decision support, facilitated medication access, and dedicated outpatient rapid-follow up.
Sponsors
University of Michigan
National Heart, Lung, and Blood Institute (NHLBI)
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Intervention model description
cluster-randomized stepped-wedge design with two or more sites assigned at each of four steps
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Participation in MEDIC collaborative * Identified site physician champion * Annual volume of acute PE ≥80 (measured in 2022)
Exclusion criteria
* Pediatric-only hospital/ED * No site physician champion identified * Annual volume of acute PE \<80 (measured in 2022) * Existing formal clinical pathway for outpatient management of low-risk PE
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in proportion of patients discharged home from Emergency Department (ED) | 3 months Pre-intervention, Up to 18 months Post-intervention | Reported by participating center indicating the proportion of patients discharged home from ED |
Countries
United States
Contacts
STUDY_CHAIRGeoff Barnes
University of Michigan
Outcome results
None listed