HEARt Sounds: Audio Recordings to Improve Discharge Communication for Cardiology Inpatients
- Conditions
- Cardiovascular Disease
- Interventions
- Other: Audio Recording
- Registration Number
- NCT03735342
- Lead Sponsor
- Dartmouth-Hitchcock Medical Center
- Brief Summary
Ineffective hospital discharge communication can significantly impact patient understanding, safety, and treatment adherence. This is especially true for cardiology patients, who leave the hospital with complex discharge plans, a multitude of high-risk medications, post-procedural care instructions and recommendations for drastic lifestyle changes, all delivered in a time-pressured discharge discussion. The goal of this pilot trial is to determine if it is possible to use audio recordings to supplement usual discharge communication to improve cardiology patients' ability to understand and self-manage care after leaving the hospital.
- Detailed Description
The study objective is to assess the feasibility and acceptability of providing audio recorded discharge instructions to patients discharged from an inpatient cardiology service using a two-arm randomized controlled design. Specifically, this pilot study aims to: 1) Determine whether providing audio recorded discharge instructions as a supplemental discharge communication tool is feasible for cardiology providers and patients to use during the inpatient discharge discussion, 2) Determine whether it is acceptable for patients and families to use audio recorded discharge instructions after hospital discharge to self-manage care, and 3) Explore the impact of audio recording on patients' understanding of discharge instructions, ability to self-manage care and ability to adhere to prescribed medications.
On the day of discharge, enrolled patients will be randomized to a usual care arm, which includes bedside discussion and review of written discharge instructions with the discharging provider, or to an intervention arm, which includes bedside discussion and review of written discharge instructions with the discharging provider and an audio recording of that bedside discharge discussion using block randomization at the provider level. All participants randomized to the intervention arm will receive a portable, electronic recording device with audio playback that contains a recording of the bedside discharge discussion, and will also have the option to record the discharge discussion on a smartphone or receive access to the recording online, via the Open Recording Automated Logging System (ORALS). The hypothesis is providing audio recordings of discharge instructions will be feasible and acceptable to cardiology patients and providers.
One week after discharge, all enrolled patients (both arms) will be contacted via telephone to complete an interview about the use of written discharge instructions and a survey about understanding of discharge instructions, confidence and ability to self-manage care, and medication adherence. In addition, patients in the intervention arm will be interviewed about how the audio recording of the discharge discussion was used.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 57
- 18 years of age or older
- Cardiology inpatients
- Comfortable reading and writing in English
- Willing to have discharge conversation recorded
- Patients who are unable or unwilling to provide written informed consent
- Diagnosis of dementia, schizophrenia and other psychotic disorders
- Have a substance-abuse disorder
- Severe uncorrected vision or hearing problems
- Currently living in skilled nursing facility or hospice
- Planned discharge to a structured facility (e.g., skilled nursing facility, intermediate care facility, hospice)
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Audio Recording Audio Recording Participants receive a verbal discharge discussion with a provider, written discharge instructions and a re-playable audio recording of the discharge discussion with the discharging provider.
- Primary Outcome Measures
Name Time Method Patient enrollment (Feasibility) Time 1-Day of discharge, immediately post randomization The proportion of eligible cardiology inpatients who agreed to take part in the research.
Intervention fidelity (Feasibility) Time 1-Day of discharge, immediately post randomization The proportion of cardiology inpatients in the intervention arm that received the audio recording intervention with full adherence to a pre-defined protocol fidelity checklist. Any deviations will be documented.
Patient use of intervention (Acceptability) Time 2-One week after discharge, post randomization The proportion of discharged cardiology patients in the intervention arm who used the audio recording between the day of discharge and a one-week follow up telephone call initiated by the research team.
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (1)
Dartmouth Hitchcock Medical Center
🇺🇸Lebanon, New Hampshire, United States