Quasi-Randomized Evaluation of the UCLA Next Day Clinic (NDC)

Completed · Not applicable

Conditions studied: Pneumonia, Syncope, Congestive Heart Failure, Cellulitis, Pyelonephritis, AKI - Acute Kidney Injury, Diabetic Foot Infection, Osteomyelitis

In brief

The Next Day Clinic (NDC) is a quality improvement initiative that will be launched and operated by UCLA Health starting July 22, 2024. Its goals are to improve patient care and safety and to maximize cost effectiveness. The way it does this is by identifying patients in the ED who would normally be admitted for low-acuity conditions, and diverting them to a high-acuity clinic the following day called the NDC. This will help decompress the ED and the hospital, and allow for overall higher quality care. The Health System has partnered with UCLA's Healthcare Value Analytics and Solutions \[UVAS\] group which specializes in these types of program evaluations. The analysis conducted by the study team will be used to directly inform NDC operations, scaling, and future plans.

Key facts

Study ID

NCT06526884

Run by

University of California, Los Angeles

People needed

570

Starts

2024-07-22

Expected to finish

2026-03-31

Last updated by the study team

2026-05-18

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• 18 years of age or older
• About to be admitted through the ED for one of the NDC diagnoses or a synonym (per Study Protocol document), defined by the presence of a Plan to Admit order or Bed Request order, OR recently admitted under observation or inpatient status for one of the NDC diagnoses.
• Identified as at-risk for an avoidable hospitalization in the ED based on a pre-determined set of lab and vital parameters.
• Insurance that authorizes the patient to follow-up at UCLA Health, or self-pay
• Admitted or being admitted to an internal medicine service

You may not qualify if…

• Heart or lung transplant recipient with concern for graft dysfunction
• Pregnant
• Enrolled in hospice
• Admitted to a critical care service
• ED deems discharge unsafe due to complex social or medical factors
• Active malignant cancer (per Council of State and Territorial Epidemiologists value set)
• Pulmonary arterial hypertension (per Joint Commission value set)
• Undergoing workup for solid organ transplant
• Interstitial lung disease (including pulmonary fibrosis) (per Higher Level 7 value set)
• Requiring inpatient procedure or surgery defined by the presence of an anesthesia event or operating room encounter.
• The ED deems discharge unsafe due to complex social or medical factors.
• Transferred to an ineligible hospital
• Note:
• The Health System plans to limit the volume of referrals to the NDC by only referring patients who have an even birth date (this is more equitable than first-come-first-serve, because wage workers are more likely to come to the ED later in the day; even/odd birth date theoretically keeps more spots open for patients presenting to the ED later).

Where it is running

• Ronald Reagan UCLA Medical Center — Los Angeles, California, United States

Full record on ClinicalTrials.gov

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