Identifying Adverse Events After Discharge From a Community Hospital

NCT01536340 | Completed

• 1 other identifier: R01HS018694
• Study Type: observational
• Target: 684
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to:

• Determine the incidence of adverse events, preventable adverse events, and ameliorable adverse events, and the timeliness of post-discharge ambulatory appointments, affecting urban and rural patients approximately 3-4 weeks after discharge from a hospitalist-run medical service of a large community hospital to home. H1: The incidence of post-discharge adverse events will be higher in rural patients compared with urban patients discharged from a hospitalist-run medical service of a large community hospital.
• Identify and classify the types of post-discharge adverse events (e.g., adverse drug events, procedure-related events, hospital acquired (nosocomial) infections, falls, and other) affecting urban and rural patients approximately 3-4 weeks after discharge from a hospitalist-run medical service of a large community hospital to home. H2: All patients will be at higher risk for adverse drug events than other types of adverse events.
• Examine the relationships between the population at risk, characteristics of the health care delivery system, and the utilization of post-discharge health services, and how these relationships help us understand the incidence of post-discharge adverse events. H3: Several factors will be independently associated with the incidence of post-discharge adverse events in rural and urban patients, including patient comorbidity, severity of acute illness, presence of a primary care physician prior to hospitalization, and a scheduled timely post-discharge ambulatory follow-up appointment.

Conditions

Iatrogenic Injury

Keywords

post discharge adverse events; discontinuities in care; medical injury

Outcome Measures

Primary Outcomes (1)

• post discharge adverse event

  Patients are contacted 3-6 weeks after discharge for a phone interview. They are questioned about potential adverse events following their discharge from the hospital. Interviewers/nurses conduct a review of systems to determine if the patient experienced an adverse event. Potential cases are flagged on the basis of unexpected health care utilization, new/exacerbated symptoms and/or abnormal lab test results. Cases are reviewed by two independent physician reviewers to determine whether the adverse event was preventable, using their implicit judgment.

  six weeks after discharge from the hospital

Eligibility Criteria

• Age: 21 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Our study population includes patients 21 and older living in Florida, who are discharged home from the TMH hospitalist service. Patients must have a phone number where they can be reached. They must also speak English or Spanish. Surrogates are permitted to complete an interview in the event that a patient is unable to complete it. Rural patients are those who live in counties where the population density is 100 people per square mile or less. Patients with diminished mental capacity are at increased risk of adverse events. These patients (or their surrogates) are included in the sample.

You may qualify if:

• age over 21 years
• discharged home from TMH general medical service
• patients must have a telephone number where they can be reached for an interview
• patient or surrogate must be able to interview in Spanish or English

You may not qualify if:

• age less than 21 years
• patient or surrogate non-English or Spanish speaking
• patients being discharged to an institutionalized care (assisted living facilities, prisons, etc.)
• patients not discharged from general medical service

Sponsors & Collaborators

• Florida State University: lead
• Agency for Healthcare Research and Quality (AHRQ): collaborator

Study Sites (1)

Tallahassee Memorial Healthcare

Tallahassee, Florida, 32301, United States

Location

Related Publications (1)

• Tsilimingras D, Schnipper J, Duke A, Agens J, Quintero S, Bellamy G, Janisse J, Helmkamp L, Bates DW. Post-Discharge Adverse Events Among Urban and Rural Patients of an Urban Community Hospital: A Prospective Cohort Study. J Gen Intern Med. 2015 Aug;30(8):1164-71. doi: 10.1007/s11606-015-3260-3. Epub 2015 Mar 31.

  PMID: 25822112 BACKGROUND

Study Officials

• Dennis Tsilimingras, MD, MPH

  Wayne State University

  PRINCIPAL INVESTIGATOR

• Ashley Duke

  Florida State University, College of Medicine

  STUDY DIRECTOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: School of Medicine

Study Record Dates

• First Submitted: February 16, 2012
• First Posted: February 22, 2012
• Study Start: September 1, 2011
• Primary Completion: October 1, 2012
• Study Completion: October 1, 2014
• Last Updated: May 25, 2015

Record last verified: 2015-05

Locations

US (1)