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Main
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Note: This record shows only 22 elements of the WHO Trial Registration Data Set. To view changes that have been made to the source record, or for additional information about this trial, click on the URL below to go to the source record in the primary register. |
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Register:
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ISRCTN |
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Last refreshed on:
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13 January 2015 |
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Main ID: |
ISRCTN11113729 |
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Date of registration:
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01/03/2006 |
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Prospective Registration:
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No |
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Primary sponsor: |
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Public title:
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Evaluation of the impact of a discharge coordinator on continuity of care from hospital to home
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Scientific title:
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Date of first enrolment:
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20/06/2005 |
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Target sample size:
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160 |
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Recruitment status: |
Completed |
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URL:
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http://isrctn.com/ISRCTN11113729 |
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Study type:
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Interventional |
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Study design:
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Randomised controlled trial (Other)
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Phase:
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Countries of recruitment
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Canada
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Contacts
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Name:
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Sharon
Straus |
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Address:
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Toronto Western Hospital
399 Bathurst street
M5T 2S8
Toronto
Canada |
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Telephone:
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Email:
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Affiliation:
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Name:
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Key inclusion & exclusion criteria
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Inclusion criteria: Participants will be patients who:
1. Will be in hospital for more than 48 hours
2. Who are greater than 65 years of age
3. Who have a diagnosis of acute coronary syndrome, congestive heart failure, pneumonia, exacerbation of chronic obstructive airways disease, falls, or confusion
Participants will also undergo a Short Portable Mental Status Questionnaire and must score above 5 out of 10 questions.
Exclusion criteria: Patients will be excluded if they score less than 5 on the Short Portable Mental Status Questionnaire, or if they are transferred to another in-patient service at an acute care hospital
Age minimum:
Age maximum:
Gender:
Both
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Health Condition(s) or Problem(s) studied
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Continuity of care from hospital to home
Not Applicable
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Intervention(s)
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Only patients who have been admitted as an in-patient with a diagnosis of acute coronary syndrome, congestive heart failure, pneumonia, exacerbation of chronic obstructive airways disease, falls, or confusion will be approached to participate.
During the intervention phase, patients admitted to a general medical in-patient unit at the Toronto Western Hospital with one of the six common medical diagnoses noted above will be randomly allocated either to receive care from a discharge coordinator or to usual care.
Computer generated randomisation will be used in blocks of six and randomisation will be stratified by living arrangements (e.g. from long-term care facility or independent living accommodation) and by ability to speak English. Randomisation is being used because one discharge coordinator would not be able to provide care for all eligible patients and it is unclear from the literature how this intervention should be targeted. Allocation will be concealed.
All four Clinical Teaching Units (CTUs) at this hospital will participate in this study. Letters inviting participation in this study will be sent from the General Internal Medicine Program Director to all medicine residents assigned to the CTUs during the study period. Letters of invitation will also be sent from the General Internal Medicine Division Director to all staff physicians who will be attending on the medicine CTUs during the study period. Notification of the study will be provided to all members of the health care teams on the medical wards.
The research assistant will continue to attend bullet rounds each morning to identify eligible patients. The discharge coordinator will only be present from 9 am to 5 pm on Monday to Friday. Once eligible patients are identified, a research assistant will approach them for consent to participate as outlined above. If patients agree to participate, baseline demographics will be obtained. We will also attempt to collect baseline information from patients wh
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Primary Outcome(s)
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In this study, the primary outcome will be a composite endpoint to assess the level of discontinuity of care and will include:
1. The number of patients admitted with the target conditions who do not complete at least one recommended follow-up test
2. The number of patients admitted with the target conditions who do not attend at least one recommended follow-up appointment
3. The number of patients admitted with the target conditions who do not fill at least one medication prescribed at discharge
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Secondary Outcome(s)
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Secondary outcomes include mortality and the proportion of patients readmitted to hospital (including admissions to the Emergency Department). Reasons for readmission will be assessed to determine if a medical error had an impact on readmission. Quality of life will be assessed using the 12-item Short Form health survey (SF-12) and patient satisfaction will be assessed using the Patient Satisfaction Questionnaire which includes items on convenience of care, access to care, continuity of care, competence, explanations of care, degree of consideration shown and overall satisfaction. Outcomes will be assessed at 4, 8, and 12 weeks after the intervention has been implemented.
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Source(s) of Monetary Support
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Premier's Research Excellence Awards (Canada)
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Results
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Results available:
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Date Posted:
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Date Completed:
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URL:
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