Implementing a case management intervention for frequent users of the emergency department (I-CaM): an effectiveness-implementation hybrid trial study protocol.

TitreImplementing a case management intervention for frequent users of the emergency department (I-CaM): an effectiveness-implementation hybrid trial study protocol.
Publication TypeJournal Article
Year of Publication2019
AuthorsGrazioli, VS, Moullin, JC, Kasztura, M, Canepa-Allen, M, Hugli, O, Griffin, J, Vu, F, Hudon, C, Jackson, Y, Wolff, H, Burnand, B, Daeppen, J-B, Bodenmann, P
JournalBMC health services research
Date Published01/2019
Mots-clésAdolescent, Adult, Aged, Case Management, Case Management/statistics & numerical data, Developed Countries, Emergency Service, Facilities and Services Utilization, Frequent users of the emergency department, Hospital/statistics & numerical data, Humans, Implementation science, Middle Aged, Multicenter Studies as Topic, Patient Acceptance of Health Care/statistics & numerical data, Quality of Life, Research Design, Switzerland, Vulnerability, Young Adult

BACKGROUND: ED overcrowding represents a significant public health problem in developed countries. Frequent users of the emergency departments (FUEDs; reporting 5 or more ED visits in the past year) are often affected by medical, psychological, social, and substance use problems and account for a disproportionately high number of ED visits. Past research indicates that case management (CM) interventions are a promising way to reduce ED overcrowding and improve FUEDs' quality of life. There is, however, very limited knowledge about how to disseminate and implement this intervention on a large scale to diverse clinical settings, including community hospitals and non-academic centers. This paper describes the protocol of a research project aiming to implement a CM intervention tailored to FUEDs in the public hospitals with ED in the French-speaking region of Switzerland and evaluate both the implementation process and effectiveness of the CM intervention.

METHODS: This research project uses a hybrid study design assessing both implementation and clinical outcomes. The implementation part of the study uses mixed methods a) to describe quantitatively and qualitatively factors that influence the implementation process, and b) to examine implementation effectiveness. The clinical part of the study uses a within-subject design (pre-post intervention) to evaluate participants' trajectories on clinical variables (e.g., quality of life, ED use) after receiving the CM intervention. We designed the study based on two implementation science frameworks. The Generic Implementation Framework guided the overall research protocol design, whereas the RE-AIM (reach, efficacy, adoption, implementation and maintenance) framework guided the implementation and effectiveness evaluations.

DISCUSSION: This research project will contribute to implementation science by providing key insights into the processes of implementing CM into broader practice. This research project is also likely to have both clinical and public health implications.

TRIAL REGISTRATION: NCT03641274 , Registered 20 August 2018.

Alternate URL



Alternate JournalBMC Health Serv Res
Citation Key / SERVAL ID9326
Peer reviewRefereed
PubMed ID30634955
PubMed Central IDPMC6330435
Grant List407440_167341 / / Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung /


Institut universitaire de médecine sociale et préventive
Route de la Corniche 10, 1010 Lausanne - Switzerland
+41 21 314 72 72 |

Go to top