Optimizing the Safety of Inter-Hospital Transfer

NCT05876429 | Completed

• 1 other identifier: 2020P001945
• Study Type: interventional
• Target: 1,658
• Locations: 1 country
• Sites: 1

Brief Summary

This proposal aims to design, implement and rigorously evaluate a standardized accept note in a population of patients that have high frequency of IHT, including patients transferred to the general medical (GMS), cardiology and oncology services at a large tertiary care hospital. This study will improve scientific knowledge by quantifying the patient safety impact of an intervention to improve communication of essential clinical information during IHT. If shown effective, the results of this study can be used to improve clinical practice by establishing evidence-based communication guidelines for broad dissemination. We will also establish technical feasibility by successfully implementing this tool within our EHR (Epic, Verona, WI), allowing for feasible adoption and dissemination to other institutions with similar EHR capabilities. Lastly, we will address malpractice risk by investigating a strategic intervention aimed at reducing known contributors to patient harm during IHT, a high-risk transition in care that involves transfer of high-acuity patients between providers, settings and systems of care.

Conditions

Inpatient Facililty Diagnoses

Outcome Measures

Primary Outcomes (1)

• clinician-reported medical errors and adverse events

  Medical errors and adverse events measured as the total number of medical errors per patient

  Up to 2 weeks

Secondary Outcomes (8)

• Presence of any adverse event after transfer

  up to 2 weeks

• Preventable adverse event after transfer

  up to 2 weeks

• Ameliorable adverse event after transfer

  up to 2 weeks

• Length of stay of hospitalization after transfer

  up to 2 weeks

• ICU-transfer within 24 hours of transfer

  Up to 24 hours

Study Arms (2)

Pre-Intervention: Current Transfer Process

ACTIVE COMPARATOR

Control: Transfer patients are admitted per usual based on existing processes for GMS, Cardiology, and Oncology services. Data collection assesses clinician reported feedback on the logistics for each patient transfer, and issues along the transfer supply chain.

Other: Existing Transfer Patient Admission Process

Post-Intervention: Implementing Standardized Accept Note

EXPERIMENTAL

Intervention Arm: After engaging stakeholders and finalizing a standardized accept note for transfer patients, appropriate staff will be trained on the use of the note and the note will be implemented in the transfer patient admission process. Data collection will assess clinician reported feedback on the logistics for each patient transfer, and issues along the transfer supply chain, post-intervention.

Other: New Standardized Accept Note

Interventions

New Standardized Accept Note OTHER

A standardized accept note for transfer patients will be implemented, after stakeholder engagement and subsequent finalization.

Post-Intervention: Implementing Standardized Accept Note

Existing Transfer Patient Admission Process OTHER

Maintain existing transfer patient admission processes, across GMS, Cardiology, and Oncology services.

Pre-Intervention: Current Transfer Process

Eligibility Criteria

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

You may qualify if:

• source of admission is inpatient transfer from another acute care hospital
• admitted to general medical service
• admitted to cardiology service
• admitted to oncology service
• admitted to ICU service
• age \>= 18

You may not qualify if:

• source of admission is other than inpatient transfer
• admitted to service other than listed above
• age \< 18

Sponsors & Collaborators

• Brigham and Women's Hospital: lead
• Crico: collaborator

Study Sites (1)

Brigham & Women's Hospital

Boston, Massachusetts, 02115, United States

Location

Study Officials

• Stephanie Mueller, M.D., M.P.H.

  Brigham and Women's Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Physician

Study Record Dates

• First Submitted: April 6, 2023
• First Posted: May 25, 2023
• Study Start: August 17, 2020
• Primary Completion: July 15, 2022
• Study Completion: June 30, 2023
• Last Updated: January 23, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)