A Randomized Controlled Trial of Geriatric Emergency Department Innovations
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 822
- 试验地点
- 1
- 主要终点
- Number of patients with hospital admission or death
研究概览
简要总结
This study evaluates the Geriatric Emergency Department Innovations (GEDI) program at Northwestern Memorial Hospital to care for older adults in the emergency department. Half of the patients will be cared for by a standard ED team plus the GEDI team, while half of the patients will receive usual ED care.
详细描述
Hospitalization is common for older adults in the Emergency Department (ED) but it carries significant risks including the development of delirium, falls, and nosocomial infections. The Geriatric Emergency Department Innovations (GEDI) program at Northwestern Memorial Hospital attempts to identify and address health related risks for older adults without exposing them to the risks of hospitalization,. GEDI is a unique program consisting of a multidisciplinary team of Transitional Care Nurses (TCN), social workers, pharmacists, occupational therapists and physical therapists who perform ED-based geriatric assessment and care coordination.
To determine the impact of GEDI on health services use and Health Related Quality-of-Life (HRQoL) we will conduct a randomized controlled trial comparing GEDI compared to usual ED care(which often involves hospitalization).
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 (Participant)
入排标准
- 年龄范围
- 65 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Northwestern Emergency Department patients who are:
- •65 years or older
- •living independently or with friends, family, or caregivers in the community
- •Clinical Frailty Scale (CFS) score of 4 or greater
排除标准
- •Patients will be excluded if they:
- •Tested positive for COVID-19
- •Are unable to complete the assessments in English
- •Are unable to provide informed consent with no Legally Authorized Representative Present or are unable to complete follow-up participation
- •Are held in the ED involuntarily as a prisoner or patient with a psychiatric complaint
- •Are enrolled in another study to avoid patient fatigue and confounding
- •Received a GEDI, Social Work, Pharmacy, or Physical Therapy consult outside of this trial during the current ED visit
- •Leave the ED against medical advice or without being seen by a physician
- •Are admitted to the ICU
- •Are too medically unstable to participate in the assessment
研究组 & 干预措施
Control
Standard emergency department care
Intervention
Standard emergency department are plus GEDI consult
干预措施: Intervention (Behavioral)
结局指标
主要结局
Number of patients with hospital admission or death
时间窗: 30 days
A composite measure of any hospitalizations or death during the index ED visit or within the follow up time frame
次要结局
- Death(30 days)
- PROMIS-Preference(30 days)
- Return Emergency Department Visits(30 days)
- PROMIS Item Bank v2.0 - Physical Function (Adaptive)(30 days)
- PROMIS Item Bank v2.0 - Ability to Participate Social Roles and Activities (Adaptive)(9 days)
- PROMIS Item Bank v. 1.0 - Emotional Distress - Depression (Adaptive)(30 days)
- Number of patients admitted(30 days)
- PROMIS Item Bank v2.0 - Ability to Participate Social (Adaptive)(30 days)
- PROMIS Item Bank v. 1.0 - Emotional Distress - Anxiety (Adaptive)(30 days)
- Number of patients with hospital admission or death(9 days)
- PROMIS-Preference(9 days)
- Return Emergency Department Visits(9 days)
- Death(9 days)
- PROMIS Item Bank v2.0 - Physical Function (Adaptive)(9 days)
- PROMIS Item Bank v. 1.0 - Emotional Distress - Anxiety (Adaptive)(9 days)
- PROMIS Item Bank v. 1.0 - Emotional Distress - Depression (Adaptive)(9 days)
- Number of patients admitted(24 hours)
- Number of patients admitted(9 days)
研究者
Scott Dresden
Assistant Professor
Northwestern University