Ensayos clínicos

Inclusion Criteria - Aim 1:

• Clinicians (physicians, Nurse Practitioners, Physician Assistants), nurses, community paramedics, administrators, care coordinators, and other stakeholders likely to be engaged in the CACP program.

Inclusion Criteria - Aim 2:

• Adults (age ≥ 18 years) who are:
  • Currently admitted to the ED, hospital; or are
  • In a pre-hospital setting but being considered for referral to the ED or hospital at Mayo Clinic Rochester, MN and Barron, WI but do not require hospital-level monitoring or care other than services that could be delivered by CPs in the ambulatory setting if such services were available to them.
• Eligible participants have to reside within an approximately 40-mile radius of Rochester, MN or within the service radius of Barron, WI. 
• Participants who require assistance with activities of daily living, or who are at increased risk for falls, need to have a caregiver available at home. For the purposes of the trial, “residence” and “home” refer to the place where the participant will be physically located after clinic, ED, or hospital discharge, and can include a hotel or another housing arrangement (i.e., not only their permanent residence).

Inclusion Criteria - Aim 3:

• All community paramedics (up to 18), clinicians who referred participants enrolled in the CACP intervention arm (up to 100), administrators involved with the CACP program (up to 30), and Mayo Clinic Ambulance leaders (up to 20) will be surveyed. 
• All community paramedics (up to 18), purposive sample of participants enrolled in the CACP intervention arm (up to 35), and a purposive sample of clinicians, administrators, administrators, and Ambulance leaders (up to 35) will be interviewed.
• Patient participants will be purposively sampled to ensure diversity of geography, age, sex, race and ethnicity, and clinical diagnosis for CACP program referral. Clinician and administrator participants will be purposively sampled to ensure representation of different ED and hospital service lines and frequency of referrals to the CACP program.

Exclusion Criteria - Aim 1:​​

•  
• ​​​No exclusion criteria.

Exclusion Criteria - Aim 2:​​

• Referring clinician believes the patient requires referral to the ED (for patients in the pre-hospital setting) or hospital admission (for patients in the ED or hospital)
• Not meeting criteria outlined in the Community Paramedic Referral Guide
• Inability or unwillingness of individual or legal guardian/representative to give written informed consent.
• Clinical, behavioral, or cognitive instability, determined by the referring clinician or the CACP service
• Living conditions unsafe for CPs to enter (e.g., patient refuses to secure weapons or animals prior to CP’s arrival)
• Enrolled in the trial during an earlier hospitalization or ED visit.

Exclusion Criteria - Aim 3:​​

• There will be no exclusion criteria for Aim 3 clinicians or other clinical or administrative stakeholders.
• Patient participants will be excluded if they:
  • Have a communication barrier due to medical illness or cognitive impairment; or
  • Are seriously ill or hospitalized at the time of interview recruitment.

Eligibility last updated 3/16/22. Questions regarding updates should be directed to the study team contact.