STUDY PROTOCOL article
Front. Health Serv.
Sec. Health Policy and Management
Volume 5 - 2025 | doi: 10.3389/frhs.2025.1524552
Patient navigation in German emergency care (NODE). Study protocol of a multi-center mixed-methods trial
Provisionally accepted
Daniela Krüger*
Maria AltendorfFelix HolzingerCornelia Wäscher
Martin MöckelChristoph Heintze
Judith Stumm
Konrad Schmidt
Anna Slagman- Charité University Medicine Berlin, Berlin, Germany
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Background & Objective: The objective of the study is to explore and to evaluate existing patient navigation models between emergency departments (ED) and alternative outpatient emergency care providers. Therefore, three different patient navigation models in emergency care in Berlin, Germany will be evaluated regarding their efficiency, quality of care, patient safety, patient satisfaction, costs and cost-effectiveness: (1) a hospital-owned separate outpatient care model within the ED premises or on the hospital grounds, (2) an urgent care practice of the Regional Association of Statutory Health Insurance (SHI) Physicians at the ED location, and (3) a standard care ED with prospective assessment of patient-care and urgency levels by ED doctors. secondary endpoints: secondary efficiency, patient-reported outcome measures (PROMs), patient safety, quality of care, clinical outcomes, and cost-effectiveness; participant observation of patients' treatment trajectories and organizational processes at three different patient navigation models (n~10-15), an online provider survey; and 4) data triangulation and recommendations for practice and policy.Discussion: This is the first study to compare different patient navigation and cooperation models to standard ED care in Germany and evaluate their effectiveness. Results will provide deep insights into the efficiency, patient satisfaction, quality of care, patient safety and cost-effectiveness. This will help providers and policymakers organise future emergency care in Germany. The study is expected to contribute to health services and systems research. Trial registration: DRKS00030398.
Keywords: health care reform1, patient navigation2, emergency care3, outpatient care4, emergency department (ED)5, low-acuity6, cross-sector cooperation7, mixed-methods8
Received: 17 Jan 2025; Accepted: 21 Jul 2025.
Copyright: © 2025 Krüger, Altendorf, Holzinger, Wäscher, Möckel, Heintze, Stumm, Schmidt and Slagman. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Daniela Krüger, Charité University Medicine Berlin, Berlin, Germany
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