A Pragmatic, Randomized, Controlled Trial Examining the Effectiveness of a Hospital Discharge Follow-up Phone Call Program
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 3,054
- 试验地点
- 2
- 主要终点
- Number of Participants With In-patient Re-admissions
研究概览
简要总结
The goal of this project is to quantify the impact of post-hospital discharge follow-up phone calls on hospital readmission, ED visits, patient satisfaction, and mortality in a general medicine inpatient population. We will obtain exploratory information on patient sub-groups at high risk for hospital readmission and on those experiencing high benefit from the follow-up phone call intervention. In addition, we will obtain data on discharge plan implementation assistance needed to support a successful transition from inpatient to outpatient care among those reached by the intervention phone call.
详细描述
RATIONALE
In the current medical literature, it is unclear how follow-up calls influence these outcomes in a general medical population. Some studies have attempted to address this question, but are limited in that they target very specific patient populations, are of insufficient quality, or evaluated follow-up calls as part of a larger care bundle. We will conduct a high quality, real-time clinical care study to determine the efficacy of a follow-up phone call program.
STUDY DESIGN
This is a single center, pragmatic, randomized, controlled clinical trial to investigate whether a structured post-hospital discharge follow-up phone call can improve patients' transition from in-hospital to outpatient care and improve satisfaction with their care. We will also identify the discharge implementation assistance given to those in the intervention (Phone Call) group.
Outcome Measures Primary outcome for this study is readmission event rate within 30 days. Secondary outcomes include patient satisfaction which will be measured as mean Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction scores, all cause VUMC emergency department (ED) visits, the need for assistance with discharge plan implementation, and 30 day mortality.
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
- 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
- •VUMC patients discharged after an inpatient status hospital stay on a general medicine service.
排除标准
- •patients who experience in-hospital death
- •patient discharged to any post-acute care facility or inpatient hospice
- •left the hospital against medical advice
研究组 & 干预措施
Phone Call Group (Intervention Arm)
Follow-up phone call intervention: Patients will receive the first call attempt within 72 hours of hospital discharge with a maximum of 3 call attempts by the study nurse made up until post-discharge day 7. The semi-structured script embedded within the program specific electronic health record Discharge Phone Call Starform is used to guide a conversation to obtain information on potential causes of hospital readmission that can be identified and addressed to improve each patient's transition to outpatient care.
干预措施: Follow-up Phone Call (Behavioral)
Usual Care Group (Control Arm)
Patients assigned to the control group receive standard discharge planning and follow-up per the usual care of their medical providers.
结局指标
主要结局
Number of Participants With In-patient Re-admissions
时间窗: 30 days
Number of participants with in-patient re-admissions
次要结局
- Patient Satisfaction: Experience(Within 60 days of Discharge)
- Patient Satisfaction: Likelihood to Recommend the Facility (Top Box Rating)(Within 60 days of Discharge)
- Patient Satisfaction: Hospital Experience (Top Box Rating)(Within 60 days of Discharge)
- Patient Satisfaction: Likelihood to Recommend the Facility(Within 60 days of Discharge)
- VUMC Emergency Department (ED) Visits(30 days)
- Number of Patient Received Discharge Plan Implementation Assistance(30 days)
- Mortality(30 days)
研究者
Maame Yaa A. B. Yiadom
MD, MPH, MSCI, Assistant Professor
Vanderbilt University Medical Center