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OpenTrials
Completed

NCT Number: NCT06933849

Coordinated Emergency Department Transitions

The goal of this observational study is to learn the feasibility, acceptability, appropriateness, and adherence to a case management intervention. PartnerED is a case management intervention that aims to reduce unnecessary hospital admissions by providing real-time, structured information and discharge support to emergency department providers via phone and fax. The intervention is led by chronic care managers employed by Bluestone Accountable Care Organization, a physician group primarily serving patients in assisted living centers.

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Key information

Conditions

Alzheimer Disease or Associated Disorder Alzheimer Disease Brain Diseases Central Nervous System Diseases Dementia Disease Attributes Emergencies Mental Disorders Nervous System Diseases Neurocognitive Disorders Neurodegenerative Diseases Pathologic Processes Pathological Conditions, Signs and Symptoms Tauopathies

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Bluestone Accountable Care Organization

Omaha, Nebraska, 68154, United States

About this study

PartnerED is a case management intervention that aims to reduce unnecessary hospital admissions by providing real-time, structured information and discharge support to emergency department providers via phone and fax. The intervention is led by chronic care managers employed by Bluestone Accountable Care Organization, a physician group primarily serving patients in assisted living centers.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Bluestone Accountable Care Organization patient
  • Registration in emergency department between November 1, 2023 and June 30, 2024, as recorded in electronic admission, discharge, and transfer notifications

Exclusion criteria

  • None

Treatment and study plan

Structured case management

Behavioral

When a Bluestone Accountable Care Organization registers in an emergency department, a Bluestone chronic care manager contacts emergency department clinicians by phone and fax to provide up-to-date clinical and discharge support information.

Primary outcomes

  1. Percent of Eligible Emergency Department Visits With Completed Outreach

    Time frame: Within 1-3 hours of emergency department registration

    Percent of eligible emergency department visits in which a case manager provided structured clinical and discharge support information to a emergency department provider about a patient who was in their care, with the goal of avoiding an unnecessary hospitalization

Secondary outcomes

  1. Percent of Successful Outreach Conversations in Which Staff Reported Avoidance of an Unnecessary Hospitalization

    Time frame: Within 24 hours of emergency department registration

    Case manager self-report of whether she/he was successful in avoiding an unnecessary hospitalization of a patient after providing structured clinical and discharge support information to the emergency department provider

Sponsors and collaborators

Lead sponsor

Brown University

Other

Collaborators

  • National Institute on Aging (NIA)

Registry information

Official study title

PartnerED Care: Coordinated Emergency Department Transitions for Assisted Living Patients With Alzheimer's Disease and Related Dementias

Important dates

Study start
2024
Primary completion
2025
Study completion
2025
First posted
Apr 18, 2025
Registry last updated
May 27, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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