Improving communication about diagnostic uncertainty in the emergency department
Targeted EHR-based Communication of Diagnostic Uncertainty (TECU) in the ED: An Effectiveness Implementation Trial
This study is testing a new way to help doctors talk to patients about unclear diagnoses when they leave the emergency room to see if it can reduce confusion and prevent them from coming back.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 300 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Thomas Jefferson University Academic / other |
| Locations | 1 site (Philadelphia, Pennsylvania) |
| Trial ID | NCT06638021 on ClinicalTrials.gov |
What this trial studies
This clinical trial evaluates the effectiveness and feasibility of a new strategy called Targeted EHR-based Communication about Uncertainty (TECU) aimed at enhancing care transitions for patients discharged from the emergency department (ED) with uncertain diagnoses. The approach involves using electronic health records to prompt clinicians to communicate uncertainty effectively and provide patients with informational handouts. The study will compare the TECU strategy to standard discharge practices to assess its impact on reducing patient uncertainty and return visits to the ED. Additionally, it will explore barriers and facilitators to implementing this strategy from both patient and clinician perspectives.
Who should consider this trial
Good fit: Ideal candidates for this study are English-speaking adults aged 18 years or older who are being discharged from the ED with a symptom-based diagnosis and can complete follow-up assessments.
Not a fit: Patients who are clinically unstable, psychologically impaired, or unable to provide informed consent will not benefit from this study.
Why it matters
Potential benefit: If successful, this approach could significantly improve patient understanding and management of their health after discharge, potentially reducing unnecessary return visits to the ED.
How similar studies have performed: Previous studies have indicated that improved communication strategies in healthcare settings can enhance patient outcomes, suggesting that this approach may be promising.
Eligibility criteria
Show full inclusion / exclusion criteria
Patient Inclusion Criteria: * 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 Patient Exclusion Criteria: * 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)
Where this trial is running
Philadelphia, Pennsylvania
- Thomas Jefferson University — Philadelphia, Pennsylvania, United States (Recruiting)
Study contacts
- Principal investigator: Kristin L Rising, MD, MS — Thomas Jefferson University
- Study coordinator: Kristin L Rising, MD, MS
- Email: kristin.rising@jefferson.edu
- Phone: 2673031359
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.