Comparison Between Two Strategies of Discharge Planning for the Reduction of Short Term Hospital Readmissions: A Cluster Randomized Cross-over Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 802
- 试验地点
- 2
- 主要终点
- Unexpected hospital readmission within 90 days from discharge
研究概览
简要总结
The purpose of this study is to improve discharge planning effectiveness by comparing two strategies [on-Demand Discharge Planning (DDP) vs. Routine Discharge Planning (RDP)], in terms of reduction of hospital readmissions for inpatients classified at intermediate risk of complex discharge using the simplified Blaylock Risk Assessment Screening Score (BRASS).
详细描述
The purpose of this study is to improve discharge planning effectiveness by comparing two strategies [on-Demand Discharge Planning (DDP) vs. Routine Discharge Planning (RDP)], in terms of reduction of hospital readmissions for inpatients classified at intermediate risk of complex discharge using the simplified Blaylock Risk Assessment Screening Score (BRASS).
Five Internal Medicine Unit and four Units of Neurology will be randomized to the two different strategies of discharge planning (RDP or DDP), based on two different alternating sequences of four periods (each period comprising three months). The randomization will be stratified by type of unit.
Patients at risk of complex discharge, according to the simplified BRASS score, are assigned to the Hospital Unit of Continuity of Care (NOCC) team, using the hospital telematics system. Afterwards, the NOCC team proposes an appropriate discharge planning, considering clinical and social needs.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Other
- 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 patients (age ≥ 18 years);
- •Residents in Piedmont, Italy;
- •Patients admitted to General Internal Medicine or Neurology Units of Molinette Hospital (Turin)
- •Patients with a score in the simplified BRASS between 4 and 6 at admission
- •No specific
排除标准
- •were applied.
结局指标
主要结局
Unexpected hospital readmission within 90 days from discharge
时间窗: 90 days
Proportion of hospital admissions in the standard admission regime within 90 days from the date of discharge. The endpoint will be calculated only for patients discharged alive. Readmissions for any cause under ordinary admissions will be considered as event. The Day Hospital re-admissions will not be considered for the endpoint calculation.
次要结局
- Death within 90 days from discharge(90 days)
- Proportion of Long Length of Stay (LLOS)(150 days)
- Healthcare costs until 90 days from the discharge(90 days)
- Proportion of patients reported to the NOCC team during the DDP-experimental phase(150 days)
研究者
Daniela Corsi
MD, Director of "SSD Integrazione Ospedale-Territorio"
A.O.U. Città della Salute e della Scienza