Patient navigation in German emergency care (NODE). Study protocol of a multi-center mixed-methods trial

Area of Science:

• Health Services Research
• Emergency Medicine
• Health Policy

Background:

• Existing patient navigation models between emergency departments (EDs) and alternative outpatient emergency care providers require evaluation.
• Three distinct models in Berlin, Germany, are assessed: a hospital-owned outpatient model, a regional health insurance physician practice, and standard ED care.
• The study aims to compare these models against standard ED care.

Purpose of the Study:

• To explore and evaluate existing patient navigation models linking emergency departments (EDs) with outpatient emergency care providers.
• To assess the efficiency, quality of care, patient safety, patient satisfaction, costs, and cost-effectiveness of three different patient navigation models in emergency care.
• To provide recommendations for practice and policy in organizing future emergency care in Germany.

Main Methods:

• A convergent, parallel, mixed-methods, multi-center study design is employed.
• Qualitative methods include systematic literature review, semi-structured patient interviews, and focus groups with healthcare providers.
• Quantitative methods involve a prospective multi-center cohort study of adult emergency patients, participant observation, and an online provider survey.

Main Results:

• The study is the first in Germany to compare patient navigation models with standard ED care.
• Results will offer insights into efficiency, patient satisfaction, quality of care, patient safety, and cost-effectiveness.
• Data triangulation will inform recommendations for practice and policy.

Conclusions:

• The findings will guide providers and policymakers in organizing future emergency care in Germany.
• The study is expected to contribute significantly to health services and systems research.
• Comparative evaluation of navigation models is crucial for optimizing emergency care delivery.