Cirrhosis Care Alberta (CCAB): A Pragmatic Type II Hybrid Effectiveness Implementation Trial Evaluating the Effectiveness of a Standardized Order Set
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 3,975
- 试验地点
- 2
- 主要终点
- Cumulative hospital length of stay (LOS) per patient year
研究概览
简要总结
Liver cirrhosis is the leading cause of morbidity and premature mortality in patients with digestive disease. There are many gaps in care which contribute to a high rate of hospital readmissions (44 percent at 90 days) and inadequate quality of care. Currently, there is a lack of structured processes to initiate best practice support for medical and broader health needs of high risk patients.
The cirrhosis care Alberta program (CCAB) is a 3 year multi-component quality improvement initiative which will aim to improve quality of care, reduce acute care utilization and be satisfactory to both patients and providers. Best practice support will be provided in the areas of: Evidence based management of cirrhosis, alcohol use support, frailty, advance care planning, home-hospital-home transitions including standardized outpatient monitoring and structured urgent access for rapid, on-demand outpatient assessment.
详细描述
Cirrhosis Care Alberta (CCAB) is a 3 year multi-component system-wide quality improvement trial which aims to improve quality of care, reduce acute care utilization and meet the needs of both patients and providers throughout Alberta. Instead of addressing just a single contributor to acute care utilization, this ambitious intervention will be the first in the world to bring together care providers across the province to tackle the complex multilevel problem with a multilevel solution. The intervention includes implementation of our standardized integrated strategy for delivering evidence-based best practices under real-world conditions to address the key determinants of hospital readmission and length of stay (LOS) in patients admitted with cirrhosis.
The CCAB project intervention includes:
-
Comprehensive Care Bundle (development underway):
-
Admission and Discharge/Transition order set focused on the screening and management of:
- Cirrhosis complications
- Frailty and malnutrition
- Alcohol use disorder and
- Transition to community
- Patient and caregiver education
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Sequential
- 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
- •Adults (great than 18 years of age) with a clinical diagnosis of cirrhosis (confirmed by compatible radiology, histology or fibroscan)
- •Admitted to a study hospital site
- •Exclusion Criteria
- •o Adult patients who do not have cirrhosis
排除标准
- 未提供
结局指标
主要结局
Cumulative hospital length of stay (LOS) per patient year
时间窗: Baseline, 1 year, 2 year
LOS
次要结局
- Emergency Department (ED) Visit Rate(Baseline,through study completion, an average of 1 year)
- Survival(Baseline,through study completion, an average of 1 year)
- Mean Length of Stay (LOS) (Ward, ICU, Total)(Baseline,through study completion, an average of 1 year)
- Readmission rate at 90 days(From commencement of the study (baseline), assessed quarterly until study completion.)
- Hospital Readmission Rate(Baseline,through study completion, an average of 1 year)
- Outpatient Visit rate(Baseline,through study completion, an average of 1 year)
- Disease severity(Baseline,through study completion, an average of 1 year)
- Implementation fidelity(From commencement of the study (baseline), assessed quarterly until study completion.)