Physician Engagement in EMS Transport Refusal Rates

NCT07107737 | Recruiting

• 1 other identifier: IRB00134848
• Study Type: interventional
• Target: 250
• Locations: 1 country
• Sites: 1

Brief Summary

The primary goal of this study is to find out if patients who speak with an EMS physician over the phone are less likely to refuse care compare to patients who do not speak with an EMS physician.

Conditions

Refusal of Transport

Keywords

EMS transport; emergency treatment; EMS protocol

Outcome Measures

Primary Outcomes (1)

• Number of Patients Transported

  Number of patients who agreed to be transported by EMS

  Day 1

Secondary Outcomes (4)

• Number of Patients Admitted to Hospital

  Day 1

• Number of Patients Discharged from Emergency Department

  Day 1

• Duration of EMS Interaction

  Day 1

• Number of EMS Same-Day Return

  Hour 24 Post Initial Call

Study Arms (2)

Physician Consultation

EXPERIMENTAL

Mecklenburg EMS agency (MEDIC) crew chiefs (EMTs and/or paramedics) may decide, based on patient circumstances, to consult OMC for patients wishing to refuse care.

Behavioral: Physician Consultation

Standard of Care

ACTIVE COMPARATOR

Refusal-of-care consultation not provided to patient

Behavioral: Standard of Care

Interventions

Standard of Care BEHAVIORAL

Every other month will be randomized to either Physician Consultation or Standard of Care. During the months designated for Standard of Care, physician intervention will not be provided. For safety reasons, if physicians or EMS MEDIC clinicians feel that speaking with the patient is important to provide additional clinical benefit, they may do so without hesitation and can override the designated intervention month.

Standard of Care

Physician Consultation BEHAVIORAL

Every other month will be randomized to either Physician Consultation or Standard of Care. During the months designated for Physician Consultation, direct communication between the patient and a designated physician by phone will be implemented when a patient refuses transport in cases where the EMS clinician feels that physician consultation is warranted for further guidance. The physician will attempt to address patient concerns and provide additional medical advice.

Physician Consultation

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adult patients ≥18 years old in care of Mecklenburg EMS (MEDIC) on an emergency basis (911 call) who wish to refuse transportation to the hospital in whom MEDIC has, via existing processes and decision-making, engaged online medical control EMS Physicians for further guidance

You may not qualify if:

• Patients \<18 years old.
• Patient refuses to speak with online medical control EMS Physicians. MEDIC or patient requests to have primary care physician.
• Lack of clinical capacity.
• Incarcerated population.

Sponsors & Collaborators

• Wake Forest University Health Sciences: lead

Study Sites (1)

Atrium Health Carolinas Medical Center

Charlotte, North Carolina, 28203, United States

RECRUITING

MeSH Terms

Interventions

Standard of Care

Intervention Hierarchy (Ancestors)

Quality Indicators, Health Care; Quality of Health Care; Health Services Administration; Health Care Quality, Access, and Evaluation

Study Officials

• Stephen Tyler Constantine, MD

  Atrium Health Carolinas Medical Center

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Stephen Tyler Constantine

CONTACT

704-355-3181; stephen.constantine@advocatehealth.org

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 30, 2025
• First Posted: August 6, 2025
• Study Start: April 12, 2026
• Primary Completion (Estimated): October 1, 2026
• Study Completion (Estimated): November 1, 2026
• Last Updated: July 1, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)