Comparison Between Two Strategies of Discharge Planning for the Reduction of Short Term Hospital Readmissions

NCT03436940 | Completed

• 1 other identifier: CS2/378/2017
• Study Type: interventional
• Target: 802
• Locations: 1 country
• Sites: 1

Brief Summary

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).

Conditions

Patient Discharge

Outcome Measures

Primary Outcomes (1)

• Unexpected hospital readmission within 90 days from discharge

  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.

  90 days

Secondary Outcomes (4)

• Proportion of Long Length of Stay (LLOS)

  150 days

• Death within 90 days from discharge

  90 days

• Proportion of patients reported to the NOCC team during the DDP-experimental phase

  150 days

• Healthcare costs until 90 days from the discharge

  90 days

Study Arms (2)

On Demand Discharge Planning (DDP)

ACTIVE COMPARATOR

Patients with an intermediate score, according to the simplified Blaylock Risk Assessment Screening Score, are addressed to the NOCC team only in case of a specific request by the unit of hospitalization.

Other: On Demand Discharge Planning (DDP)

Routine Discharge Planning (RDP)

EXPERIMENTAL

All patients with an intermediate threshold value of the simplified Blaylock Risk Assessment Screening Score are submitted to discharge planning by the NOCC team (Hospital Unit of Continuity of Care)

Other: Routine Discharge Planning (RDP)

Interventions

On Demand Discharge Planning (DDP) OTHER

Patients with an intermediate score, according to the simplified Blaylock Risk Assessment Screening Score, are addressed to the NOCC team (hospital Continuity of care team) only in case of a specific request by the unit of hospitalization.

On Demand Discharge Planning (DDP)

Routine Discharge Planning (RDP) OTHER

All patients with an intermediate threshold value of the simplified Blaylock Risk Assessment Screening Score are submitted to discharge planning by the NOCC team (Hospital Unit of Continuity of Care)

Routine Discharge Planning (RDP)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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

Sponsors & Collaborators

• A.O.U. Città della Salute e della Scienza: lead

Study Sites (1)

AOU Città della Salute

Torino, 10100, Italy

Location

Related Publications (1)

• Evangelista A, Camussi E, Corezzi M, Gilardetti M, Fonte G, Scarmozzino A, La Valle G, Angelone L, Olivero E, Ciccone G, Corsi D. Routine vs. On-Demand Discharge Planning Strategy in Intermediate-Risk Patients for Complex Discharge: a Cluster-Randomized, Multiple Crossover Trial. J Gen Intern Med. 2023 Sep;38(12):2749-2754. doi: 10.1007/s11606-023-08186-4. Epub 2023 May 11.

  PMID: 37170018 DERIVED

Study Officials

• Daniela Corsi, MD

  A.O.U. Città della Salute e della Scienza

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MD, Director of "SSD Integrazione Ospedale-Territorio"

Model Details: cluster randomized cross-over trial

Study Record Dates

• First Submitted: February 13, 2018
• First Posted: February 19, 2018
• Study Start: June 1, 2018
• Primary Completion: October 12, 2019
• Study Completion: October 13, 2019
• Last Updated: March 29, 2022

Record last verified: 2022-03

Data Sharing

• IPD Sharing: Will not share

Locations

IT (1)