Regionalized Pediatric Emergency Care in Rural Pennsylvania (OUTREACH)
The overall goal of this project is to develop and evaluate an organized, regional system of pediatric emergency care in rural western Pennsylvania.
|Study Design:||Allocation: Non-Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Health Services Research
|Official Title:||Regionalized Pediatric Emergency Care in Rural Pennsylvania: the Optimizing Utilization and Rural Emergency Access for Children Study|
- Average distance from home to the nearest facility with specialized pediatric emergency care capabilities [ Time Frame: One-year ] [ Designated as safety issue: No ]This population-based outcome will act as a measure of access and relates to HRSA Maternal Child Health Bureau performance measure AHS-8 and AHS-9 (access to pre-hospital EMS and wait times)
- Incidence of emergency transfers to CHP after an index community ED visit [ Time Frame: 90 days ] [ Designated as safety issue: No ]
- Incidence of emergency transfers to CHP that do not result in a hospital admission [ Time Frame: 90 days ] [ Designated as safety issue: No ]
- Total health care encounters outside the county within three months after an index community ED visit [ Time Frame: 90 days ] [ Designated as safety issue: No ]
- Mortality after an index community ED visit for specified high-risk conditions (trauma, sepsis, and in the chronic disease population) [ Time Frame: 90 days ] [ Designated as safety issue: No ]These outcomes will address our goal to increase child health and related to the HRSA Maternal Child Health Bureau performance measures MICH-1,2 and 3
|Study Start Date:||June 2012|
|Estimated Study Completion Date:||June 2016|
|Estimated Primary Completion Date:||June 2016 (Final data collection date for primary outcome measure)|
Experimental: Multicomponent intervention
Hospitals in the experimental arm will receive a four-component intervention that integrates local education, community outreach, telemedicine and protocolized triage and transport
Other: Multicomponent intervention
Develop, implement and evaluate an organized system of regional pediatric emergency care in rural Western Pennsylvania using four pillars: education, community, protocolized triage and transport, and telemedicine.
No Intervention: Control
Hospitals in the control arm will receive usual care.
The OUTREACH project will develop, implement and evaluate an organized system of regional pediatric emergency care in rural western Pennsylvania. Toward that end the investigators have developed three broad goals: (1) to define the key barriers and potential solutions to regionalized pediatric emergency care through community stakeholder engagement; (2) to implement a regionalized system of pediatric emergency care using education, community outreach and telemedicine; and (3) evaluate the impact of the system on health care access and outcomes for rural children. The investigators will implement the intervention in a sample of rural hospitals in Pennsylvania using a staggered roll-out design, and compare outcomes of children seen in these hospitals to similar matched hospitals in the state, using Pennsylvania state Medicaid data to evaluate the impact of the intervention.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01775033
|United States, Pennsylvania|
|University of Pittburgh Medical Center|
|Pittsburgh, Pennsylvania, United States, 15261|
|Study Director:||Jeremy M Kahn, MD, MS||University of Pittsburgh|