Author:
Yiadom Maame Yaa A B,Domenico Henry,Byrne Daniel,Hasselblad Michele Marie,Gatto Cheryl L,Kripalani Sunil,Choma Neesha,Tucker Sarah,Wang Li,Bhatia Monisha C,Morrison Johnston,Harrell Frank E,Hartert Tina,Bernard Gordon
Abstract
IntroductionHospital readmissions within 30 days are a healthcare quality problem associated with increased costs and poor health outcomes. Identifying interventions to improve patients’ successful transition from inpatient to outpatient care is a continued challenge.Methods and analysisThis is a single-centre pragmatic randomised and controlled clinical trial examining the effectiveness of a discharge follow-up phone call to reduce 30-day inpatient readmissions. Our primary endpoint is inpatient readmission within 30 days of hospital discharge censored for death analysed with an intention-to-treat approach. Secondary endpoints included observation status readmission within 30 days, time to readmission, all-cause emergency department revisits within 30 days, patient satisfaction (measured as mean Hospital Consumer Assessment of Healthcare Providers and Systems scores) and 30-day mortality. Exploratory endpoints include the need for assistance with discharge plan implementation among those randomised to the intervention arm and reached by the study nurse, and the number of call attempts to achieve successful intervention delivery. Consistent with the Learning Healthcare System model for clinical research, timeliness is a critical quality for studies to most effectively inform hospital clinical practice. We are challenged to apply pragmatic design elements in order to maintain a high-quality practicable study providing timely results. This type of prospective pragmatic trial empowers the advancement of hospital-wide evidence-based practice directly affecting patients.Ethics and disseminationStudy results will inform the structure, objective and function of future iterations of the hospital’s discharge follow-up phone call programme and be submitted for publication in the literature.Trial registration numberNCT03050918; Pre-results.
Funder
National Heart, Lung, and Blood Institute
National Center for Advancing Translational Sciences
Reference32 articles.
1. Readmissions, observation, and the hospital readmissions reduction program;Zuckerman;N Engl J Med,2016
2. Center for Medicare and Medicaid Services. “Hospital Readmissions Reduction Program (HRRP)”. AHRQ, CMS.gov. https://www.cms.gov/medicare/medicare-fee-for-service-payment/acuteinpatientpps/readmissions-reduction-program.html (accessed 25 Aug 2017).
3. American Hospital Association. Fast facts on US hospitals. 2017 http://www.aha.org/research/rc/stat-studies/fast-facts.shtml (accessed 25 Aug 2017).
4. Interventions to reduce 30-day rehospitalization: a systematic review;Hansen;Ann Intern Med,2011
5. Health coaching: a new and exciting technique to enhance patient self-management and improve outcomes;Huffman;Home Healthc Nurse,2007
Cited by
9 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献