Hospital to Home Outcomes (H2O): A Study to Improve the Fluidity of Transitions Between Hospital and Home
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Focus: Hospitalized Patients
- Sponsor
- Children's Hospital Medical Center, Cincinnati
- Enrollment
- 1500
- Locations
- 1
- Primary Endpoint
- Number of Participants With Any Occurrence of Unplanned Re-hospitalization and/or Any Emergency/Urgent Care Visits Within 30 Days of Hospital Discharge
- Status
- Completed
- Last Updated
- 7 years ago
Overview
Brief Summary
Home Nurse Visit post discharge.
Detailed Description
To identify barriers to successful transitions that are most meaningful to patients and families, and use these identified barriers to iteratively adapt an existing nurse home visit program to address these barriers. This study will also test the efficacy of a nurse home visit intervention in improving post-discharge outcomes through a randomized controlled trial.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Patient is under 18 years of age Patient is admitted to Cincinnati Children's Hospital Medical Center to hospital medicine, community pediatrics, adolescent medicine, neurology or neurosurgery.
Exclusion Criteria
- •Patient to be discharged someplace other than home (e.g., residential facility, psychiatric facility)
- •Patient's home residence is outside the home nursing service area
- •Patient is eligible for "traditional" home nursing services
- •Caregiver is non-English speaking
Outcomes
Primary Outcomes
Number of Participants With Any Occurrence of Unplanned Re-hospitalization and/or Any Emergency/Urgent Care Visits Within 30 Days of Hospital Discharge
Time Frame: 30 days post-discharge
The dependent variable will be a dichotomized indicator of any occurrence of unplanned rehospitalization and/or any emergency department/urgent care visit within 30-days post-discharge (i.e. unplanned reutilization). Differences in this outcome between intervention and control groups will be evaluated using logistic regression with the stratification variables (neighborhood poverty and complex versus noncomplex teams) included in the model.
Secondary Outcomes
- Post Discharge Coping Difficulty Scale(14 days post-discharge)
- Days Until Normalcy(14 days post-discharge)
- Red Flags Remembered(14 days post-discharge)
- Number of Participants With Occurrence(s) of an Unplanned Readmission Within 30 Days Post-discharge(30 days)
- Number of Participants With Occurrence(s) of an Emergency Department Visit Within 30 Days Post-discharge(30 days)
- Number of Participants With Occurrence(s) of 14-day Unplanned Healthcare Utilization(14 days post-discharge)