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Implementing a Case-management Intervention for Frequent Users of the Emergency Department in French-speaking Switzerland

NCT03641274 · Status: UNKNOWN · Type: OBSERVATIONAL · Enrollment: 120

Last updated 2019-04-26

No results posted yet for this study

Summary

Background. Emergency department (ED) overcrowding represents a significant public health problem in developed countries. Frequent users of the emergency departments (FUEDs; reporting 5 or more ED visits in the past year) are often affected by medical, psychological, social, and substance use problems and account for a disproportionately high number of ED visits. Past research indicates that the case management (CM) intervention is a promising way to reduce ED overcrowding and improve FUEDs' quality of life. There is, however, very limited knowledge about how to disseminate and implement this intervention on a large scale to diverse clinical settings, including community hospitals and non-academic centers. This research project aims to implement a CM intervention tailored to FUEDs in the public hospitals with ED in the French-speaking region of Switzerland and to evaluate both the implementation process and effectiveness of the CM intervention. Methods. This research project will examine both implementation and clinical outcomes. The implementation part of the study will describe quantitatively and qualitatively factors that influence the implementation process; the investigators will also examine implementation effectiveness (i.e., whether the implementation of the CM intervention in the ED was successful or not). The clinical part of the study will evaluate participants' trajectories on clinical variables (e.g., quality of life, ED use) after receiving the CM intervention. Discussion. This research project will contribute to implementation science by providing key insights into the processes for implementing CM into broader practice. This research project is also likely to have both clinical and public health implications.

Conditions

  • Frequent Users of Emergency Department (FUEDs)

Interventions

OTHER

Case-management intervention for frequent users of the emergency department

The CM intervention to be implemented is an evidence-based practice. It consists of individualized services based on a detailed baseline evaluation using validated scales to identify all of the social and medical needs of each FUED. The CM team provides counseling and education on health care utilization, substance abuse and the social determinants of health directly to the FUEDs, using skills such as motivational interviewing and cross-cultural competences. Additionally, the CM team provides concrete services including, referral to psychiatric or substance abuse treatment, or medical services (such as a GP or medical specialist), on a case-by-case basis. Another key element of the CM intervention is to connect all health care or social service providers within the hospital or in the community, promoting continuity of care and improving the FUEDs' ability to navigate the complex health care system.

Sponsors & Collaborators

  • University of Lausanne Hospitals

    lead OTHER

Principal Investigators

  • Patrick Bodenmann, MD MSc · University of Lausanne Hospitals

Eligibility

Min Age
18 Years
Sex
ALL
Healthy Volunteers
No

Timeline & Regulatory

Start
2018-11-20
Primary Completion
2018-11-20
Completion
2020-10-31

Countries

  • Switzerland

Study Locations

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Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT03641274 on ClinicalTrials.gov