Improving Safety of Transitions to Skilled Nursing Care Using Videoconferencing

NCT03832257 | Completed

• 1 other identifier: 2018P000457
• Study Type: interventional
• Target: 10,708
• Locations: 1 country
• Sites: 1

Brief Summary

This prospective cohort study seeks to determine if the ECHO-CT program, a healthcare videoconferencing program, can improve clinical outcomes while reducing cost and resource utilization when expanded to a community hospital setting. Data will be analyzed on the facility level and patient level.

Conditions

Acute Disease

Outcome Measures

Primary Outcomes (1)

• 30-Day Readmission Rates

  Number of hospital readmissions over 30 day period among participating SNF sites

  30-Days

Secondary Outcomes (2)

• Health Care Utilization

  up to 90 days

• Health Care Cost

  30-days

Study Arms (2)

ECHO CT Intervention

EXPERIMENTAL

Weekly video conference between hospitalist at Beth Israel and skilled nursing facilities.

Other: ECHO CT Intervention

Matched Non- Participating Facilities

OTHER

Matched non-participating facilities

Other: Matched Non-Participating Facilities

Interventions

ECHO CT Intervention OTHER

weekly video conference between hospitalist and skilled nursing facilities

ECHO CT Intervention

Matched Non-Participating Facilities OTHER

Matched Non-Participating Facilities

Matched Non- Participating Facilities

Eligibility Criteria

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

You may qualify if:

• SNF receives approximately the middle third of referral volume (approx. 20-100 referrals/ average 40 per year)
• SNF not so highly engaged with acute hospital that their patients are less likely to benefit from the intervention.
• SNF affiliated with BIDMC Boston or BIDMC Needham

You may not qualify if:

• Has not recently participated in ECHO CT
• Do not send anyone to ECHO CT training
• Clinicians are unwilling to make a commitment to attend at least 75% of video conferences
• Patient Selection:
• ECHO-CT Group:
• Control Group:

Sponsors & Collaborators

• Beth Israel Deaconess Medical Center: lead
• Brown University: collaborator
• Hebrew SeniorLife: collaborator

Study Sites (1)

Beth Israel Deaconess Medical Center

Boston, Massachusetts, 02215, United States

Location

Related Publications (11)

• Arora S, Thornton K, Jenkusky SM, Parish B, Scaletti JV. Project ECHO: linking university specialists with rural and prison-based clinicians to improve care for people with chronic hepatitis C in New Mexico. Public Health Rep. 2007;122 Suppl 2(Suppl 2):74-7. doi: 10.1177/00333549071220S214.

  PMID: 17542458 BACKGROUND

• Arora S, Thornton K, Murata G, Deming P, Kalishman S, Dion D, Parish B, Burke T, Pak W, Dunkelberg J, Kistin M, Brown J, Jenkusky S, Komaromy M, Qualls C. Outcomes of treatment for hepatitis C virus infection by primary care providers. N Engl J Med. 2011 Jun 9;364(23):2199-207. doi: 10.1056/NEJMoa1009370. Epub 2011 Jun 1.

  PMID: 21631316 BACKGROUND

• Boltz M, Parke B, Shuluk J, Capezuti E, Galvin JE. Care of the older adult in the emergency department: nurses views of the pressing issues. Gerontologist. 2013 Jun;53(3):441-53. doi: 10.1093/geront/gnt004. Epub 2013 Feb 26.

  PMID: 23442380 BACKGROUND

• Coleman EA, Berenson RA. Lost in transition: challenges and opportunities for improving the quality of transitional care. Ann Intern Med. 2004 Oct 5;141(7):533-6. doi: 10.7326/0003-4819-141-7-200410050-00009.

  PMID: 15466770 BACKGROUND

• Kessler C, Williams MC, Moustoukas JN, Pappas C. Transitions of care for the geriatric patient in the emergency department. Clin Geriatr Med. 2013 Feb;29(1):49-69. doi: 10.1016/j.cger.2012.10.005.

  PMID: 23177600 BACKGROUND

• Moore AB, Krupp JE, Dufour AB, Sircar M, Travison TG, Abrams A, Farris G, Mattison MLP, Lipsitz LA. Improving Transitions to Postacute Care for Elderly Patients Using a Novel Video-Conferencing Program: ECHO-Care Transitions. Am J Med. 2017 Oct;130(10):1199-1204. doi: 10.1016/j.amjmed.2017.04.041. Epub 2017 May 25.

  PMID: 28551043 BACKGROUND

• Marks C, Loehrer S, McCarthy D. Hospital readmissions: measuring for improvement, accountability, and patients. Issue Brief (Commonw Fund). 2013 Sep;24:1-8.

  PMID: 24044140 BACKGROUND

• Mor V, Intrator O, Feng Z, Grabowski DC. The revolving door of rehospitalization from skilled nursing facilities. Health Aff (Millwood). 2010 Jan-Feb;29(1):57-64. doi: 10.1377/hlthaff.2009.0629.

  PMID: 20048361 BACKGROUND

• LaMantia MA, Scheunemann LP, Viera AJ, Busby-Whitehead J, Hanson LC. Interventions to improve transitional care between nursing homes and hospitals: a systematic review. J Am Geriatr Soc. 2010 Apr;58(4):777-82. doi: 10.1111/j.1532-5415.2010.02776.x.

  PMID: 20398162 BACKGROUND

• Austin BJ. Rehospitalization from skilled nursing facilities: implications for policy. Find Brief. 2010 Feb;12(9):1-3.

  PMID: 20222212 BACKGROUND

• Ouslander JG, Diaz S, Hain D, Tappen R. Frequency and diagnoses associated with 7- and 30-day readmission of skilled nursing facility patients to a nonteaching community hospital. J Am Med Dir Assoc. 2011 Mar;12(3):195-203. doi: 10.1016/j.jamda.2010.02.015. Epub 2010 Aug 12.

  PMID: 21333921 BACKGROUND

MeSH Terms

Conditions

Acute Disease

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor of Medicine

Study Record Dates

• First Submitted: February 3, 2019
• First Posted: February 6, 2019
• Study Start: September 30, 2018
• Primary Completion: August 31, 2023
• Study Completion: August 31, 2023
• Last Updated: November 30, 2023

Record last verified: 2023-11

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)