The CARS Study: Communicating About Readiness (for Discharge)
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 604
- 试验地点
- 2
- 主要终点
- Emergency Department visits
研究概览
简要总结
The purpose of this study is to improve the experience of discharge of adult medical surgical patients through improved discharge preparation communication between patients and care team members, with subsequent improvement in the post-discharge experience. Obtaining multiple perspectives on discharge readiness creates the opportunity for patient and care team to partner in identifying deficiencies in discharge readiness that warrant anticipatory, compensatory, or corrective interventions prior to discharge, with the goal of averting post-discharge problems and utilization. The results will also inform development and translation of tools for assessment of discharge readiness to clinical care environments.
详细描述
Specific Aims are to:
- Describe patterns of communication about discharge and collaboration among members of the health care team
- Conduct psychometric testing of 3 forms of the Readiness for Hospital Discharge Scale (RHDS - MD, RN, Patient)
- Describe relationships between care team communication, patient perceptions of quality of discharge preparation and perceived readiness for discharge, care team (RN and MD) assessments of discharge readiness, and post-discharge outcome ( post-discharge coping difficulty, Emergency Department (ED) use, and 30 day readmission.
- Determine the impact of an intervention with the inpatient care team to improve discharge preparation communication.
H1: Patient perceptions of discharge readiness, post-discharge coping difficulty, ED use and readmission will improve following a care team educational intervention about discharge preparation, compared to pre-intervention baseline measures.
H2: Care team members will report improved frequency and amount of discharge preparation communication following a care team educational intervention about discharge preparation, compared to pre-intervention baseline measures.
H3: RN-MD collaboration will increase following a care team educational intervention about discharge preparation, compared to pre-intervention baseline measures
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Sequential
- 主要目的
- Other
- 盲法
- None
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
- •inpatient care team members from 2 nursing units of an academic medical center: Attending physician, resident, medical students, mid-level providers, staff RNs, and case managers/discharge coordinators
- •adult medical-surgical patients admitted the 2 nursing units who are at least 18 years of age, speak English, and discharged directly home
排除标准
- •patient discharged home with hospice care
- •patients not discharged directly home
- •decisionally incapacitated patients
研究组 & 干预措施
Control pre-intervention
Usual care control before implementation of the health team communication intervention
Health team educational intervention
Agency for Healthcare Research and Quality (AHRQ) TeamSTEPPS approach will be used to redesign health team communication processes regarding preparation for discharge. This redesign will be followed by education for all health team members.
干预措施: Health Team Educational Intervention (Other)
结局指标
主要结局
Emergency Department visits
时间窗: 30 days post discharge
ED visits within the 30 days after hospital discharge
Readmission
时间窗: 30 days post discharge
Readmission within the 30 days after hospital discharge
次要结局
- Post-discharge Coping Difficulty Scale(14 to 21 days post-hospitalization)
研究者
Marianne Weiss
Associate Professor
Marquette University