Opportunities in Outpatient Care


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Primary Outcome Measures:

  • Incidence rate of avoidable ED visits due to a “missed” opportunity in outpatient care [ Time Frame: 1 Day ]

    The proportion of ED visits during the selected shifts that were deemed to be potentially avoidable according to the developed taxonomy

  • Incidence rate of avoidable InstaCare visits due to a “missed” opportunity in outpatient care [ Time Frame: 1 Day ]

    The proportion of Instacare visits during the selected shifts that were deemed to be potentially avoidable according to the developed taxonomy

Secondary Outcome Measures:

  • Patient Disposition Status from the ED [ Time Frame: 1 Day ]

    Disposition status from after the ED visit, collected from the medical record. Status will be one of the following: admitted, observation, transfer to facility, discharged, deceased.

  • Patient Disposition Status from the InstaCare [ Time Frame: 1 Day ]

    Disposition status from after the Instacare visit, collected from the medical record. Status may be admitted, observation, transfer to facility, discharged, or deceased.

  • Length of stay for admitted patients [ Time Frame: Up to 30 days ]

    Length in stay by days in study patients admitted to the hospital

  • Harms to patients due to the missed opportunities in outpatient care. [ Time Frame: 90 days ]

    Categorization of the “harms” on patients due to the missed opportunities in outpatient care using NCC-MERP categorizations

  • 30 day episode costs [ Time Frame: 30 days ]

    All attributable healthcare costs accrued to study patients from the date of visit to +30 days.

  • 90 day episode costs [ Time Frame: 90 days ]

    All attributable healthcare costs accrued to study patients from the date of visit to +90 days.

The study will develop a first-pass taxonomy that classifies the causes and effects of challenges and opportunities of outpatient care leading to potentially avoidable ED and urgent care center visits.

The study will quantify the proportion of ED and urgent care center visits that result from a challenge or opportunity in outpatient care and classify the causes and outcomes according to the taxonomy. It will also define the 30 and 90 day episode costs of ED and urgent care center visits associated with a challenges and opportunities of outpatient care beginning the day of the ED or urgent care center visit.