Validation and Implementation Design of a Pragmatic Randomized Controlled Trial Leveraging Epic Systems 30-day Unplanned Readmission Risk Model
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Unplanned Hospital Readmissions
- Sponsor
- Wake Forest University Health Sciences
- Enrollment
- 68
- Locations
- 1
- Primary Endpoint
- Number of transitional and supportive care services (TSC) referrals by providers in the Control group
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
The objective is to assess the implementation of a computerized clinical decision support (cCDS) tool for identifying patients at high risk of unplanned readmission who could benefit from existing care programs aimed at reducing readmissions
Detailed Description
Providers from either service, which includes attending physicians, residents, hospitalists, and advanced practice providers (APPs), will be randomly allocated to an intervention group (IG) or control group (CG). The IG will consist of placing the Epic 30-day unplanned readmission risk score in the story board of providers. If a patient is identified as having a high risk of readmission defined as readmission risk \>20%, a link to transitional and supportive care services (TSC) will be appear in the story board. Providers will determine which TSC is best for the patient and may order whichever TSC is appropriate for the patient. The study team will not recommend TSCs. The risk of readmission score will be present from the time of admission for those in the IG. The CG will have the same TSC orders available to them; however, they will not have the risk of readmission score present in their workflow, as such the embedded link to TSC will also not be present.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Patients of Atrium Health Wake Forest Baptist Hospital (AHWFBH)
- •18 years or older
- •meeting inpatient criteria
- •admitted to hospitalist or general medicine teaching services
- •Providers on the hospitalist or general medicine teaching services
Exclusion Criteria
- •Psychiatric diagnoses during index or subsequent admission
- •left Against Medical Advice (AMA)
- •planned readmission
- •died during index admission
- •Providers who opt out of the study
Outcomes
Primary Outcomes
Number of transitional and supportive care services (TSC) referrals by providers in the Control group
Time Frame: Day 30
Number of transitional and supportive care services (TSC) referrals by providers in the Control group
Number of transitional and supportive care services (TSC) referrals by providers in the Intervention group- High Risk Readmission Program (HRI)
Time Frame: Day 30
Number of transitional and supportive care services (TSC) referrals by providers in the Intervention group - High Risk Readmission Program (HRI)
Number of transitional and supportive care services (TSC) referrals by providers in the Intervention group
Time Frame: Day 30
Number of transitional and supportive care services (TSC) referrals by providers in the Intervention group
Number of transitional and supportive care services (TSC) referrals by providers in the Control group - Care Plus
Time Frame: Day 30
Number of transitional and supportive care services (TSC) referrals by providers in the Control group - Care Plus
Number of transitional and supportive care services (TSC) referrals by providers in the Intervention group - Faith Health
Time Frame: Day 30
Number of transitional and supportive care services (TSC) referrals by providers in the Intervention group - Faith Health
Number of transitional and supportive care services (TSC) referrals by providers in the Control group - Population Health Pharmacy
Time Frame: Day 30
Number of transitional and supportive care services (TSC) referrals by providers in the Control group - Population Health Pharmacy
Number of transitional and supportive care services (TSC) referrals by providers in the Control group - Faith Health
Time Frame: Day 30
Number of transitional and supportive care services (TSC) referrals by providers in the Control group - Faith Health
Number of transitional and supportive care services (TSC) referrals by providers in the Control group - Geriatrics Transitional Care
Time Frame: Day 30
Number of transitional and supportive care services (TSC) referrals by providers in the Control group - Geriatrics Transitional Care
Number of transitional and supportive care services (TSC) referrals by providers in the Intervention group - Geriatrics Transitional Care
Time Frame: Day 30
Number of transitional and supportive care services (TSC) referrals by providers in the Intervention group - Geriatrics Transitional Care
Provider Satisfaction Score
Time Frame: Day 30
Provider satisfaction with clinical decision support tool measured by survey
Number of transitional and supportive care services (TSC) referrals by providers in the Control group - High Risk Readmission Program (HRI)
Time Frame: Day 30
Number of transitional and supportive care services (TSC) referrals by providers in the Control group - High Risk Readmission Program (HRI)
Number of transitional and supportive care services (TSC) referrals by providers in the Intervention group - Population Health Pharmacy
Time Frame: Day 30
Number of transitional and supportive care services (TSC) referrals by providers in the Intervention group - Population Health Pharmacy
Number of transitional and supportive care services (TSC) referrals by providers in the Intervention group - Mobile Health Clinic
Time Frame: Day 30
Number of transitional and supportive care services (TSC) referrals by providers in the Intervention group - Mobile Health Clinic
Number of transitional and supportive care services (TSC) referrals by providers in the Control group - Mobile Health Clinic
Time Frame: Day 30
Number of transitional and supportive care services (TSC) referrals by providers in the Control group - Mobile Health Clinic
Number of transitional and supportive care services (TSC) referrals by providers in the Intervention group - Care Plus
Time Frame: Day 30
Number of transitional and supportive care services (TSC) referrals by providers in the Intervention group - Care Plus
Secondary Outcomes
- 30 day Readmission Rate(Day 30)