Garnering Effective Telehealth 2 Help Optimize Multidisciplinary Team Engagement
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 638
- 试验地点
- 2
- 主要终点
- Urgent healthcare reutilization
研究概览
简要总结
The purpose of this study is to determine the effectiveness of the GET2HOME Intervention bundle.
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
- Double (Investigator, Outcomes Assessor)
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients with complex chronic disease based on a Pediatric Medical Complexity Algorithm (PMCA) score of 3 and their families and their primary care providers
- •Discharged from pediatric hospital medicine service at our hospital
排除标准
- •Patients who live independently without a parent or guardian in the home, including those that live at skilled nursing facilities
- •Patients admitted for end of life care
- •Patients admitted for suicidal or homicidal ideation
- •Patients who previously enrolled in the study
- •Patients in county custody
研究组 & 干预措施
Standard Hospital-Based Care Coordination
Patients and families randomized to this arm will receive best practice standard of care hospital-based transition planning in the hospital with routine outpatient care team follow-up post-discharge.
GET2HOME Intervention
The GET2HOME intervention includes: 1) a pre-discharge telehealth huddle with the family, inpatient team, primary care team, and home care nursing; 2) a visual discharge task tracker (DTT) to monitor progress across care management tasks; and if desired by family and primary care 3) a post-discharge telehealth huddle 2-7 days after discharge with the family, inpatient team, primary care team, and home care nursing
干预措施: GET2HOME Intervention (Behavioral)
结局指标
主要结局
Urgent healthcare reutilization
时间窗: 30-days post-discharge
Yes/no to any: unplanned hospital readmission, ED revisit, or urgent care visit
次要结局
- Global Quality of Life Scale(7-, 30-, 60-, and 90-days post-discharge)
- Return to baseline(7-, 30-, 60-, and 90-days post-discharge)