A Virtual Ward to Reduce Readmissions After Hospital Discharge
试验速览
- 阶段
- 不适用
- 入组人数
- 1,928
- 试验地点
- 5
- 主要终点
- Composite of readmission to hospital or death.
研究概览
简要总结
The purpose of this study is to see whether a Virtual Ward reduces readmissions after hospital discharge.
详细描述
We will conduct a pragmatic, randomized controlled trial to evaluate a new model of care for high-risk medical patients after discharge from hospital. This new model of care has two key elements. First, we will use the LACE index (see citation below for details) to identify patients who are at high risk of readmission or death after hospital discharge. These patients will be randomized to either the Virtual Ward or usual care on the day of discharge. Although patients being cared for in the Virtual Ward will reside at home, they will benefit from a hospital-like interdisciplinary team, a shared set of notes, a single point of contact, round-the-clock physician availability and increased co-ordination of specialist, primary and home-based community care for several weeks after hospital discharge.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 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
- •Discharge from medical service
- •LACE score greater than or equal to 10
- •Age greater than or equal or 18
- •Resident in Toronto Central Local Health Integration Network catchment area
- •Patient or designate able to speak English well enough for follow up telephone calls
排除标准
- •Previously enrolled in study
- •Discharged to a rehabilitation or complex continuing care facility
研究组 & 干预措施
Usual Care
干预措施: Usual care (Other)
Virtual Ward
干预措施: Virtual Ward (Other)
结局指标
主要结局
Composite of readmission to hospital or death.
时间窗: 30 days after hospital discharge
A binary outcome variable for each patient, representing either readmission to hospital or death within 30 days of hospital discharge. A research assistant blinded to the assignment will ascertain this information via telephone using a standardized script. Second, we may also ascertain this information by linking the data we collect to administrative databases housed at the Institute for Clinical Evaluative Sciences.
次要结局
- Emergency department visits(One year after discharge)
- Long-term care admission(One year after discharge)
- Death(One year after discharge)
- Composite of readmission to hospital or death.(One year after discharge)
- Composite of readmission or death(One year after discharge)
- Readmission(One year after discharge)
- Composite of readmission or death(90 days after discharge)
- Composite of readmission or death(6 months after discharge)
- Emergency department visits(30 days after discharge)
- Emergency department visits(90 days after discharge)
- Emergency department visits(6 months after discharge)
- Long-term care admission(30 days after discharge)
- Long-term care admission(90 days after discharge)
- Long-term care admission(6 months after discahrge)
- Death(90 days after discharge)
- Death(6 months after discharge)
- Death(30 days after discharge)
研究者
Irfan Dhalla
Staff Physician & Scientist
Unity Health Toronto