Trial · NCT04192799

Comparative Effectiveness of Direct Admission & Admission Through Emergency Departments for Children

NCT04192799, Not applicable, Completed, Dartmouth-Hitchcock Medical Center; results first posted 2024-10-21

3 sourcestrials-2026-11-12-0.5.0

Cite this record

ConductScience Library. Comparative Effectiveness of Direct Admission & Admission Through Emergency Departments for Children. Trials, record NCT04192799. Release trials-2026-11-12-0.5.0, 12 Nov 2026. https://conductscience.org/library/trials/NCT04192799

On this page

Trial

As registered on ClinicalTrials.gov, in the graph's capture of the registry.

Title: Comparative Effectiveness of Direct Admission & Admission Through Emergency Departments for Children
NCT number: NCT04192799
Status: Completed
Phases: Not applicable
Enrollment: 1,997 participants, actual
Lead sponsor: Dartmouth-Hitchcock Medical Center
Conditions: Hospitalization, Child Health
Interventions: Direct admission, ED admission
First posted: 2019-12-10
Last updated: 2024-10-21
Results first posted: 2024-10-21
Limitations and caveats: This study was implemented six weeks prior to the COVID-19 pandemic, which led to unprecedented changes to healthcare. Early in the pandemic, closures of primary care clinics, transitions to telehealth, and low ED volumes may have decreased DA access and improved relative timeliness of ED care. Throughout the study, pandemic-associated staffing challenges, shortages of bed availability, and pediatric unit closures (which were observed nationally) continued to impact the project.

Source ClinicalTrials.gov

Registered outcomes5

Each outcome the trial registered, primary first, in ClinicalTrials.gov's words.

List	Outcome	Time frame	Description
Primary	Timeliness of Clinical Care - Initial Therapeutic Management	within 6 hours of hospital admission	Length of time from arrival at the hospital until time of first antibiotics, IV placement, fluid administration, or other medications
Primary	Timeliness of Clinical Care - Initial Clinical Assessment	within 6 hours of hospital admission	Length of time from arrival at the hospital until first time when at least 3 vital signs were documented; if missing, time of initial brief nursing assessment
Primary	Timeliness of Clinical Care - Initial Diagnostic Testing	within 6 hours of hospital admission	Length of time from arrival at the hospital until time of initial labs and/or imaging, including "standing orders" for diagnostic testing in emergency departments
Secondary	Number of Participants With Clinical Deterioration	within 6 hours of arrival on the inpatient unit	Transfer for pediatric intensive care or rapid response calls
Secondary	Pediatric Hospitalization Admission Survey of Experience (PHASE)	Within 72 hours of hospital admission	Standardized closed-ended survey questions regarding parent-reported experience of hospital admission with respect to the admission process, communication with families, communication between providers, and the hospital space; composite measure on 0-1 scale, with higher scores indicating better family experience

Source ClinicalTrials.gov

Outcomes5

Each outcome the trial posted results for, in ClinicalTrials.gov's words.

Type	Outcome	Time frame	Population	Units	Measured as
PRIMARY	Timeliness of Clinical Care - Initial Therapeutic Management	within 6 hours of hospital admission	These analyses include only those admissions that occurred following each clinic's respective DA program start date and for whom data were obtained.	minutes	MEDIAN
PRIMARY	Timeliness of Clinical Care - Initial Clinical Assessment	within 6 hours of hospital admission	These analyses include all admissions that occurred following each clinic's respective DA program start date.	minutes	MEDIAN
PRIMARY	Timeliness of Clinical Care - Initial Diagnostic Testing	within 6 hours of hospital admission	These analyses include only those admissions that occurred following each clinic's respective DA program start date and for whom data were obtained.	minutes	MEDIAN
SECONDARY	Number of Participants With Clinical Deterioration	within 6 hours of arrival on the inpatient unit	These analyses include 145 DAs and 1852 ED admissions that occurred following each clinic's respective DA program start date.	Participants	COUNT_OF_PARTICIPANTS
SECONDARY	Pediatric Hospitalization Admission Survey of Experience (PHASE)	Within 72 hours of hospital admission	As a secondary, self-reported outcome measure, we only obtained data from the subsample of families who completed a PHASE survey.	score on a scale	MEAN

Source ClinicalTrials.gov

Results by group10

Each measurement the trial posted, group by group, in the words and numbers it posted.

Outcome	Group	Value	Spread	Units
Timeliness of Clinical Care - Initial Therapeutic Management	Direct Admission	142	Inter-Quartile Range 96.5 to 209.5	minutes
Timeliness of Clinical Care - Initial Therapeutic Management	ED Admission	153	Inter-Quartile Range 85 to 258	minutes
Timeliness of Clinical Care - Initial Clinical Assessment	Direct Admission	25	Inter-Quartile Range 19 to 31	minutes
Timeliness of Clinical Care - Initial Clinical Assessment	ED Admission	13	Inter-Quartile Range 7 to 30	minutes
Timeliness of Clinical Care - Initial Diagnostic Testing	Direct Admission	120.5	Inter-Quartile Range 83 to 171	minutes
Timeliness of Clinical Care - Initial Diagnostic Testing	ED Admission	99	Inter-Quartile Range 48 to 186	minutes
Number of Participants With Clinical Deterioration	Direct Admission	1		Participants
Number of Participants With Clinical Deterioration	ED Admission	15		Participants
Pediatric Hospitalization Admission Survey of Experience (PHASE)	Direct Admission	0.75	Standard Deviation 0.22	score on a scale
Pediatric Hospitalization Admission Survey of Experience (PHASE)	ED Admission	0.71	Standard Deviation 0.22	score on a scale

Source ClinicalTrials.gov

Participant flow80

How many started, completed or left each group, period by period.

Period	Milestone	Group	Participants	Units counted
Step 1: Months 1-6	STARTED	Sequence 1: Periods 1-4 With Direct Admission Intervention	134	18
Step 1: Months 1-6	STARTED	Sequence 2: Periods 2-4 With Direct Admission Intervention	0	0
Step 1: Months 1-6	STARTED	Sequence 3: Periods 3-4 With Direct Admission Intervention	0	0
Step 1: Months 1-6	STARTED	Sequence 4: Period 4 With Direct Admission Intervention	0	0
Step 1: Months 1-6	Patient Directly Admitted	Sequence 1: Periods 1-4 With Direct Admission Intervention	8	18
Step 1: Months 1-6	Patient Directly Admitted	Sequence 2: Periods 2-4 With Direct Admission Intervention	0	0
Step 1: Months 1-6	Patient Directly Admitted	Sequence 3: Periods 3-4 With Direct Admission Intervention	0	0
Step 1: Months 1-6	Patient Directly Admitted	Sequence 4: Period 4 With Direct Admission Intervention	0	0
Step 1: Months 1-6	Patient Admitted Through ED	Sequence 1: Periods 1-4 With Direct Admission Intervention	126	18
Step 1: Months 1-6	Patient Admitted Through ED	Sequence 2: Periods 2-4 With Direct Admission Intervention	0	0

1 to 10 of 80Source ClinicalTrials.gov

See all 80 participant flow

Adverse events2

Each adverse event the trial posted, group by group: the participants affected out of those at risk.

Type	Event	Organ system	Group	Affected	At risk	Events
serious		General disorders	Direct Admission	0	145	0
serious		General disorders	ED Admission	0	1,852	0

Source ClinicalTrials.gov

Adverse event totals6

The totals the trial posted for each group.

Total	Group	At risk
Total, all-cause mortality	Direct Admission	145
Total, all-cause mortality	ED Admission	1,852
Total, other adverse events	Direct Admission	145
Total, other adverse events	ED Admission	1,852
Total, serious adverse events	Direct Admission	145
Total, serious adverse events	ED Admission	1,852

Source ClinicalTrials.gov

Papers1

The papers the trial lists on ClinicalTrials.gov.

PMID	Listed as
33256850	DERIVED

Source PubMed

Grants0

The grants NIH RePORTER links to the trial, newest funded first: NIH's, and some of AHRQ's, CDC's, FDA's and VA's. Each shows its title, principal investigators, organization and funder in its newest year.

None in this release.

Trial comparisons3

Comparisons of the trial's two groups, calculated by ConductScience from the counts it posted.

Comparison	Source
Direct Admission vs ED Admission: Number of Participants With Clinical Deterioration	Trial comparisons
Direct Admission vs ED Admission: deaths from any cause	Trial comparisons
Direct Admission vs ED Admission: serious adverse events	Trial comparisons

Tests0

The ConductCognition tests this trial's registered outcomes name, as ScienceGraph matched them in trial-tests-2026-11-12-0.2.1.

None in this release.

Data dates

The day each source was copied for this release.

ClinicalTrials.gov: 2026-11-12; ClinicalTrials.gov
Results, from AACT: 2026-03-23; AACT
NIH grant links: 2026-11-13; NIH RePORTER

Sources 3

ClinicalTrials.gov's posted results, through CTTI's AACTFreely available. Acknowledgement requested
ClinicalTrials.govNo license stated
NIH RePORTER's clinical studies and project filesPublic domain

Each source's terms

ClinicalTrials.gov's posted results, through CTTI's AACTClinicalTrials.gov data via Aggregate Analysis of ClinicalTrials.gov (AACT), CTTI. CTTI makes its materials freely available and requests acknowledgement. https://aact.ctti-clinicaltrials.org/documentation/299
ClinicalTrials.govnone stated
NIH RePORTER's clinical studies and project filesPublic domain (NIH RePORTER)

ClinicalTrials.gov's data carry an international copyright outside the United States: https://clinicaltrials.gov/about-site/terms-conditions.

For software

Read this trial from software.

The record and each of its lists are JSON, twenty rows a page. No key.

GET https://conductscience.org/api/trials/v1/NCT04192799

GET https://conductscience.org/api/trials/v1/NCT04192799/flow?page=2

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