PATient Navigator to rEduce Readmissions
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 1,029
- 试验地点
- 2
- 主要终点
- PROMIS Emotional Distress-Anxiety (v1.0, SF4a)
研究概览
简要总结
Staying out of the hospital is valued by patients and their caregivers. Their interests converge with those of hospitals now that high 30-day readmission rates for some conditions place hospitals at risk for financial penalties from the Centers for Medicare and Medicaid Services. This study focuses on developing and testing a program that combines a community health worker (lay patient advocate, acting as a "Patient Navigator") and a peer-led telephone support line to improve patient experience during hospital to home transition.
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
- Single (Outcomes Assessor)
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
- •Age 18 years or older on date of hospital admission
- •Hospitalized at the University of Illinois Hospital, Chicago
- •Admission diagnosis, per treating physician, of pneumonia, COPD, sickle cell disease, heart failure, or myocardial infarction
- •Receive medical care on an inpatient medical service
排除标准
- •Unable to understand and speak English
- •Unable/decline to give informed consent
- •Previous participant in PArTNER
- •Planned transfer to another acute care facility
- •Planned discharge to facility other than home (e.g. long term care facility)
- •Currently on hospice or plans to discharge home to hospice
- •Current plans to leave against medical advice
研究组 & 干预措施
Usual Care
Hospital usual care
Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.
干预措施: Hospital usual care (Behavioral)
Usual Care + PArTNER
Navigator intervention: (Community health worker, peer-led telephone support line, usual care)
Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.
Community health worker: The community health worker provides social support, literacy appropriate education, and acts as a conduit between the patient and the patient's medical team
Peer-led telephone support line: The peer-led telephone support line will provide social support, peer-to-peer coaching, and facilitate communication with the patient's medical care team.
干预措施: Hospital usual care (Behavioral)
Usual Care + PArTNER
Navigator intervention: (Community health worker, peer-led telephone support line, usual care)
Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.
Community health worker: The community health worker provides social support, literacy appropriate education, and acts as a conduit between the patient and the patient's medical team
Peer-led telephone support line: The peer-led telephone support line will provide social support, peer-to-peer coaching, and facilitate communication with the patient's medical care team.
干预措施: Navigator intervention (Behavioral)
Usual Care + PArTNER
Navigator intervention: (Community health worker, peer-led telephone support line, usual care)
Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.
Community health worker: The community health worker provides social support, literacy appropriate education, and acts as a conduit between the patient and the patient's medical team
Peer-led telephone support line: The peer-led telephone support line will provide social support, peer-to-peer coaching, and facilitate communication with the patient's medical care team.
干预措施: Peer-led telephone support line (Behavioral)
结局指标
主要结局
PROMIS Emotional Distress-Anxiety (v1.0, SF4a)
时间窗: 30 days post discharge
Change in T-score from baseline to 30 days post discharge (30 days minus baseline). A change in t-score \<0 indicates improvement. A change equal to 0 indicates no change. A change \>0 indicates worsening.
PROMIS Informational Support (v2.0, SF4a)
时间窗: 30 days post discharge
Change in T-score from baseline to 30 days post discharge (30 days minus baseline). A change in t-score \<0 indicates worsening. A change equal to 0 indicates no change. A change \>0 indicates improvement.
次要结局
- PROMIS Emotional Support (v2.0, SF4a)(60 days post discharge)
- PROMIS Instrumental Support (v2.0, SF4a)(60 days post discharge)
- PROMIS Global Health, Mental (v1.1, SF)(60 days post discharge)
- Re-hospitalization or Death(60 days post discharge)
- PROMIS Global Health, Physical (v1.1, SF)(60 days post discharge)
- PROMIS Emotional Distress-Anxiety (v1.0, SF4a)(60 days post discharge)
- PROMIS Informational Support (v2.0, SF4a)(60 days post discharge)
- Death(60 days post discharge)
- ED Visit, Re-hospitalization, or Death(60 days post discharge)
- Outpatient Healthcare Visit(14 days post discharge)
研究者
Jerry Krishnan
Professor of Medicine and Public Health; Associate Vice Chancellor for Population Health Sciences
University of Illinois at Chicago