Improving Patient Prioritization During Hospital-homecare Transition

Part of paid clinical trials in New York, New York.

Sponsor
Columbia University
Study ID
NCT04136951
Status
Completed

Conditions

Eligibility Criteria

Sex
ALL
Age
18 Years - N/A
Healthy Volunteers
Not accepted

Interventions

  • PREVENT clinical decision support — OTHER
    PREVENT clinical decision support tool consideres five patient risk factors as significant predictors of patient's priority for the first homecare nursing visit: (a) Presence of wounds (either surgical or pressure ulcers); (b) a documented comorbid condition of depression; (c) need for assistive equipment, assistive person, or both for toileting; (d) number of medications; and (e) number of comorbid conditions. Each risk factor was assigned a specific score based on the logistic regression weights. For instance, for a wound (e.g., pressure ulcer, vascular ulcer), the patient received a score of 15 points. For each additional co-morbid condition, one point was added to the final score. Summing the scores for the factors generated a cumulative score. The optimal cut-off point was established based on the regression model performance statistics, indicating that patients with a score greater than 26 points are a high priority for the first nursing visit.

Study Details

This research work is focused on building and evaluating one of the first evidence-based clinical decision support tools for homecare in the United States. The results of this study have the potential to standardize and individualize nursing decision making using cutting-edge technology and to improve patient outcomes in the homecare setting.

Key Dates

Start date
Aug 1, 2023
Status verified
Sep 2025
Primary completion
Apr 1, 2024
Completion
May 1, 2024

Study Design

Enrollment
1,915 participants (actual)
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
SCREENING

Arms

  • Experimental: Experimental phase
    The PREVENT recommendation about patient homecare priority will be shared in homecare referral communication with the homecare intake coordinators. Homecare intake coordinators will be instructed to prioritize high risk patients for care.

Primary Outcome Measure

Number of Rehospitalizations Within 60 Days After Hospital Discharge [ Time Frame: Up to 60 days after hospital discharge ]

Locations (2)

FacilityCityStateZIPSite coordinators
Columbia University School of NursingNew YorkNew York10032-
Visiting Nurse Service of New YorkNew YorkNew York10033-

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