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

Inclusion Criteria:

• 18 years of age or older

• About to be admitted through the ED for one of the NDC diagnoses or a synonym (perStudy Protocol document), defined by the presence of a Plan to Admit order or BedRequest order, OR recently admitted under observation or inpatient status for one ofthe NDC diagnoses.

• Identified as at-risk for an avoidable hospitalization in the ED based on apre-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

Exclusion Criteria:

• Heart or lung transplant recipient with concern for graft dysfunction

• Pregnant

• Enrolled in hospice

• Resides in or discharged to a skilled nursing facility/acute rehabilitation facility

• 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 valueset)

• Pulmonary arterial hypertension (per Joint Commission value set)

• Undergoing workup for solid organ transplant

• Interstitial lung disease (including pulmonary fibrosis) (per Higher Level 7 valueset)

• Requiring inpatient procedure or surgery defined by the presence of an anesthesiaevent 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).