Phone conversations with EMS physicians to reduce ambulance transport refusals
The Role of Direct Physician Engagement in EMS Transport Refusal Rates: A Prospective Study
This will test whether adult patients who speak by phone with an EMS physician are less likely to refuse ambulance transport after a 911 call than those who do not.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 250 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Wake Forest University Health Sciences Academic / other |
| Locations | 1 site (Charlotte, North Carolina) |
| Trial ID | NCT07107737 on ClinicalTrials.gov |
What this trial studies
This prospective interventional trial compares transport refusal rates between adults who receive a phone consultation from an online EMS physician and those who receive standard EMS care without that consultation. Eligible participants are adults (≥18) encountered by Mecklenburg EMS (MEDIC) after a 911 call who are considering refusing transport. The primary outcome is whether the patient refuses transport to the hospital, measured and compared between the physician-consult and standard-care groups. Findings are intended to inform evidence-based EMS protocols for handling on-scene refusals.
Who should consider this trial
Good fit: Adults (18 and older) attended by Mecklenburg EMS who are considering refusing hospital transport and are managed under MEDIC processes that involve online medical control physician contact are the intended participants.
Not a fit: Patients under 18, incarcerated individuals, those lacking decision-making capacity, or those who refuse to speak with an online EMS physician are not eligible and unlikely to benefit from this protocol.
Why it matters
Potential benefit: If successful, more patients who need emergency care may accept transport and avoid harm from inappropriate refusals.
How similar studies have performed: Prior observational work suggests clinician contact can change prehospital decision-making, but randomized and prospective evidence on phone physician consultation to reduce refusals is limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: • Adult patients ≥18 years old in care of Mecklenburg EMS (MEDIC) on an emergency basis (911 call) who wish to refuse transportation to the hospital in whom MEDIC has, via existing processes and decision-making, engaged online medical control EMS Physicians for further guidance Exclusion Criteria: * Patients \<18 years old. * Patient refuses to speak with online medical control EMS Physicians. MEDIC or patient requests to have primary care physician. * Lack of clinical capacity. * Incarcerated population.
Where this trial is running
Charlotte, North Carolina
- Atrium Health Carolinas Medical Center — Charlotte, North Carolina, United States (Recruiting)
Study contacts
- Principal investigator: Stephen Tyler Constantine, MD — Atrium Health Carolinas Medical Center
- Study coordinator: Stephen Tyler Constantine
- Email: stephen.constantine@advocatehealth.org
- Phone: 704-355-3181
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.