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The CARS Study: Communicating About Readiness (for Discharge)

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ClinicalTrials.gov Identifier: NCT01873105
Recruitment Status : Completed
First Posted : June 7, 2013
Last Update Posted : April 18, 2019
Sponsor:
Collaborator:
Froedtert Hospital
Information provided by (Responsible Party):
Marianne Weiss, Marquette University

Brief Summary:
The purpose of this study is to improve the experience of discharge of adult medical surgical patients through improved discharge preparation communication between patients and care team members, with subsequent improvement in the post-discharge experience. Obtaining multiple perspectives on discharge readiness creates the opportunity for patient and care team to partner in identifying deficiencies in discharge readiness that warrant anticipatory, compensatory, or corrective interventions prior to discharge, with the goal of averting post-discharge problems and utilization. The results will also inform development and translation of tools for assessment of discharge readiness to clinical care environments.

Condition or disease Intervention/treatment Phase
Hospital Discharge Communication Processes Other: Health Team Educational Intervention Not Applicable

Detailed Description:

Specific Aims are to:

  1. Describe patterns of communication about discharge and collaboration among members of the health care team
  2. Conduct psychometric testing of 3 forms of the Readiness for Hospital Discharge Scale (RHDS - MD, RN, Patient)
  3. Describe relationships between care team communication, patient perceptions of quality of discharge preparation and perceived readiness for discharge, care team (RN and MD) assessments of discharge readiness, and post-discharge outcome ( post-discharge coping difficulty, Emergency Department (ED) use, and 30 day readmission.
  4. Determine the impact of an intervention with the inpatient care team to improve discharge preparation communication.

H1: Patient perceptions of discharge readiness, post-discharge coping difficulty, ED use and readmission will improve following a care team educational intervention about discharge preparation, compared to pre-intervention baseline measures.

H2: Care team members will report improved frequency and amount of discharge preparation communication following a care team educational intervention about discharge preparation, compared to pre-intervention baseline measures.

H3: RN-MD collaboration will increase following a care team educational intervention about discharge preparation, compared to pre-intervention baseline measures


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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 604 participants
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Intervention Model Description: Before/after implementation of a health team communication intervention. 2 samples.
Masking: None (Open Label)
Primary Purpose: Other
Official Title: The CARS Study: Communicating About Readiness (for Discharge)
Actual Study Start Date : March 2014
Actual Primary Completion Date : May 2016
Actual Study Completion Date : May 2016

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Health team educational intervention
Agency for Healthcare Research and Quality (AHRQ) TeamSTEPPS approach will be used to redesign health team communication processes regarding preparation for discharge. This redesign will be followed by education for all health team members.
Other: Health Team Educational Intervention
AHRQ TeamStepps processes will be used to redesign health team discharge communication processes and an educational intervention for health care team members

No Intervention: Control pre-intervention
Usual care control before implementation of the health team communication intervention



Primary Outcome Measures :
  1. Readmission [ Time Frame: 30 days post discharge ]
    Readmission within the 30 days after hospital discharge

  2. Emergency Department visits [ Time Frame: 30 days post discharge ]
    ED visits within the 30 days after hospital discharge


Secondary Outcome Measures :
  1. Post-discharge Coping Difficulty Scale [ Time Frame: 14 to 21 days post-hospitalization ]
    Coping difficulty after hospital discharge measured using the Post-Discharge Coping Difficulty Scale is collected via telephone followup between 14 and 21 days after hospital discharge



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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • inpatient care team members from 2 nursing units of an academic medical center: Attending physician, resident, medical students, mid-level providers, staff RNs, and case managers/discharge coordinators
  • adult medical-surgical patients admitted the 2 nursing units who are at least 18 years of age, speak English, and discharged directly home

Exclusion Criteria:

  • patient discharged home with hospice care
  • patients not discharged directly home
  • decisionally incapacitated patients

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01873105


Locations
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United States, Wisconsin
Froedtert Hospital
Milwaukee, Wisconsin, United States, 53226
Sponsors and Collaborators
Marquette University
Froedtert Hospital
Investigators
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Principal Investigator: Marianne Weiss, DNSc RN Marquette Unoversity
Principal Investigator: Kristi Opper, MS RN Froedtert Hospital

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Responsible Party: Marianne Weiss, Associate Professor, Marquette University
ClinicalTrials.gov Identifier: NCT01873105     History of Changes
Other Study ID Numbers: PRO00019092
First Posted: June 7, 2013    Key Record Dates
Last Update Posted: April 18, 2019
Last Verified: April 2019