Examining the Intervention Effectiveness of Hospital at Home for Improving Health Outcomes and Experiences for Patients, Clinicians, and Caregivers
试验速览
- 阶段
- 不适用
- 状态
- Enrolling By Invitation
- 入组人数
- 9,654
- 试验地点
- 1
- 主要终点
- 30-day readmission rate
研究概览
简要总结
The purpose of this study is to examine the implementation, intervention effectiveness, and dissemination of a digital acute care delivery model for improving selected health outcomes in the Hospital at Home population.
详细描述
The investigators will conduct a mixed-methods quasi-experimental research study that will explore the effectiveness of the Hospital at home programs using qualitative interviews and quantitative data as a means to also conduct a process evaluation related to the implementation and efficacy of Hospital at Home programs. The purpose of this pragmatic study is to inform scalability beyond the initial site for implementation within a large healthcare system with a diverse patient population located in various communities, including rural and urban locations.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
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
- •Patients 18 years and older who are admitted into the Hospital at Home program after presenting to the emergency department or who are inpatients that can be cared at home for hospital level needs
- •Patients meeting the hospital's criteria for admission by diagnosis type (e.g., heart failure, respiratory infections and inflammations, renal failure, diabetes, pneumonia, bronchitis, chronic obstructive pulmonary disease, fever and inflammatory conditions, viral illnesses, other disorders of the nervous system). Diagnoses are determined by clinicians not researchers.
- •Patients will need to reside within 30 minutes' drive time from the hospital
- •Patient caregiver inclusion criteria: (not required for patient participation):
- •Age >= 18 years old
- •as capacity to consent to study
- •Clinician or stakeholder inclusion criteria:
- •Any member of the home hospital clinical team (a healthcare professional who providing care or equipment for use in the home) who will be participating in delivery of healthcare services,
- •Any member of the hospital care teams, including the screening and recruitment of patients for the home hospital intervention and/or providing care to patients that enroll in the intervention that is provided
- •Any member of the leadership team who are involved in the operational aspects of program delivery
排除标准
- •Need for long-term facility level care or current residence in a facility of this type
- •No one will be excluded on the basis of sex or race
研究组 & 干预措施
Hospital at Home Care
The population for this study includes adult patients who are acutely ill and presenting to the emergency room, and are discharged to their home for hospital-level care in the home setting. The patients in this cohort may also include those who are discharged from the hospital early, but receive hospital-level care in the home setting.
干预措施: Digital Care Solution as supportive personalized care (Other)
Traditional Hospital Care
The population for this study includes adult patients who are acutely ill and presenting to the emergency room who elect not to be discharged, choose to be cared for in the hospital setting.
干预措施: Traditional Hospital Level Care (Other)
结局指标
主要结局
30-day readmission rate
时间窗: Up to 30 days (date of readmission from any cause, whichever came first, assessed up to 30 days)
Number of 30-day readmissions as defined by Organization using preset criteria
Patient Satisfaction at discharge
时间窗: up to 1 week
1-item measure: I would recommend this \[insert program name\] to others, assessed at discharge name\] to others.
Composite of all-cause mortality for patients admitted to digital hospital
时间窗: Up to 30 days, (date of death from any cause, whichever came first, assessed up to 30 days)
Total number of deaths over total number of patients admitted to the digital hospital.
Patient Perception of Digital Care at discharge
时间窗: up to 1 week
Results of Digital Care - Likert Scale (very satisfied to very dissatisfied)
次要结局
- Unplanned readmission within 30-days of discharge(up to 30 days)
- Length of Stay(assessed up to 2 weeks)
- Number of participants with Hospital Acquired Infections(assessed up to 1 week)
- Escalations (for management and treatment of early decompensation)(up to 2 weeks)
研究者
Colleen J Klein
Education & Research Scientist, Center for Advanced Practice, Principal Investigator
OSF Healthcare System