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临床试验/NCT03210987
NCT03210987已完成不适用

Effect of Bedside Patient Case Presentation Compared to Outside the Room Case Presentation on Patient Perception of Quality of Care and Patient Outcomes: a Randomized-controlled, Multicenter Trial

University Hospital, Basel, Switzerland1 个研究点 分布在 1 个国家目标入组 1,092 人开始时间: 2017年7月11日最近更新:
适应症
干预措施

试验速览

阶段
不适用
状态
已完成
发起方
入组人数
1,092
试验地点
1
主要终点
Subjective understanding of disease and management

研究概览

简要总结

Patient case presentations during ward rounds can take place at the bedside or outside the room. The best approach to patient case presentation is yet unclear. Thus, the overall aim of this multicenter, randomized-controlled study is to test the hypothesis that outside the room patient case presentation compared to bedside patient case presentation results in better outcomes across different dimensions including patient understanding and perception of quality of care as well as patient outcomes, physicians' preferences, perception of quality and effectiveness, and timing of the ward rounds, respectively.

详细描述

Patient-centered care may be defined as "providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions". Involving patients in all steps of the healthcare process is thus important. Yet, best presentation of patients' cases during ward rounds remains unknown. During outside the room patient case presentation, the medical team discusses difficult patient or medical issues in the team, and later presents a "patient-friendly" synthesis to the patient. Bedside patient case presentation, on the other hand, allows a patient to be part of the whole team discussion. Yet, there is concern that patients may be unable to cope with the magnitude of medical information and misunderstandings may occur. Currently, there is equipoise regarding both possibilities of patient case presentation with an important lack of trial data. We thus aim to compare the effect of bedside patient case presentation with outside the room patient case presentation during ward rounds ("Chefarztvisite") on different patient- and physician-related endpoints.

Therefore, this randomized controlled trial aims to test the hypothesis that outside the room patient case presentation compared to bedside patient case presentation results in better outcomes across different dimensions including patient understanding and perception of quality of care as well as patient outcomes, physicians' preferences, perception of quality and effectiveness, and timing of the ward rounds, respectively.

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Parallel
主要目的
Other
盲法
Single (Outcomes Assessor)

入排标准

年龄范围
18 Years 至 —(Adult, Older Adult)
性别
All
接受健康志愿者
否

入选标准

  • •Consecutive adult (>18 years) medical inpatients during their first ward round independently of their underlying disease and reason for hospital stay.

排除标准

  • •Patients with cognitive impairment, such as dementia/delirium
  • •Patients with paracusia.
  • •Patients who do not understand local language(s).
  • •Patients already included in this study

研究组 & 干预措施

patient case presentation Bedside

Active Comparator

In the bedside presentation group, patient case presentation and discussions will be at bedside with direct involvement of the patient as needed.

干预措施: patient case presentation bedside (Procedure)

patient case presentation Outside-the-room

Active Comparator

In the outside the room condition, case presentation and discussions will take place outside without the patient being present. After the case presentation and discussions the team will enter the room and give the patient a short summary of the medical situation, complete the medical information and examine the patient, as needed, and discuss the next steps.

干预措施: patient case presentation Outside-the-room (Procedure)

结局指标

主要结局

Subjective understanding of disease and management

时间窗: post ward round up to 36 h

average of the visual analog scale (VAS) score across the following three dimensions rated by the patient (0 "I have no knowledge at all about the situation" to 100 "I have best possible knowledge about the situation": I. Patients' subjective understanding of the disease II. Patients' subjective understanding of the therapeutic concept III. Patients' subjective understanding of the next steps

次要结局

  • Improvement understanding(post ward round up to 36 h)
  • Objective understanding of disease and management(post ward round up to 36 h)
  • Overall quality of care(post ward round up to 36 h)
  • Follow up health status(30 days follow up after study inclusion)
  • Follow up understanding(30 days follow up after study inclusion)
  • Follow up quality of hospital care(30 days follow up after study inclusion)
  • Follow up readmission(30 days follow up after study inclusion)
  • Timeliness(during ward round which may last from 5 up to 30 minutes)
  • Communication-specific items during ward rounds(during ward round which may last from 5 up to 30 minutes)
  • Follow up duration of hospitalization(30 days follow up after study inclusion)
  • Treating team satisfaction(post ward round up to 96 h)
  • Treating team performance(post ward round up to 96 h)
  • Treating team affect(post ward round up to 96 h)
  • Treating team preference(post ward round up to 96 h)

研究者

发起方
University Hospital, Basel, Switzerland
申办方类型
Other
责任方
Sponsor

研究点 (1)

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