A Cluster Randomized, Stepped-Wedge Evaluation of Post Discharge Utilization Among Patients With an Acute Exacerbation of Chronic Obstructive Pulmonary Disorder (COPD)
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 4,832
- 试验地点
- 8
- 主要终点
- Healthcare Utilization
研究概览
简要总结
Patients who are hospitalized at select Carolinas Healthcare System (CHS) sites with Chronic Obstructive Pulmonary Disorder (COPD) acute exacerbation symptoms will be treated per the CHS COPD Clinical Pathway. Patient outcomes will be followed, including but not limited to readmission. Patients on the pathway will also have access to navigator services.
详细描述
Patients hospitalized at participating CHS sites with COPD acute exacerbation symptoms, will be treated per the CHS COPD clinical pathway. The COPD clinical pathway will include four components: (i) discrete, evidence-based care steps (ii) patient navigation, (iii) daily data driven care gap identification, (iv) monthly leadership huddles. These components are all part of usual care for patients in this population, but each component is not applied to patients consistently across the System. For this reason, the pathway will be applied consistently and completely in patients meeting COPD acute exacerbation criteria at participating sites. Patients will be followed for 60 days in total after discharge from their COPD acute exacerbation symptoms to determine the potential effectiveness of complete implementation of all 4 components in the care of COPD patients. Patients on the pathway will also have access to navigator services.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Sequential
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 40 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Identified as having an acute exacerbation of COPD within 24 hours of admission
排除标准
- •Death during the index encounter
- •No initial discharge as of the end of the study period
研究组 & 干预措施
Intervention
A group of 4 Usual Care components that are applied consistently and completely amongst all patients who present with COPD acute exacerbation symptoms, plus access to navigator services (COPD Clinical Pathway).
干预措施: COPD Clinical Pathway (Other)
Control
Treatment of patients in the usual manner based on their diagnosis and resources available at that site (Usual Care).
干预措施: Usual Care (Other)
结局指标
主要结局
Healthcare Utilization
时间窗: 60 days
Occurrence of Emergency Department, inpatient, or observation encounters after the initial encounter at accrual
次要结局
- Quality, Comfort, and Care (QCC) Defined Readmission Rate(30 days)
- Patient-centric (Protocol Defined) Readmission Rate(30 days)
- 30-day COPD Specific, Acute Care Utilization to Any Hospital Within the System(30 day)