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CompletedNCT03436940PROMENADEUpdated Mar 29, 2022

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

An interventional study of On Demand Discharge Planning (DDP) and Routine Discharge Planning (RDP) in Patient Discharge, sponsored by A.O.U. Città della Salute e della Scienza. Completed at 1 site in Italy. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2022-03-29.

Sponsored by A.O.U. Città della Salute e della Scienza · Not applicable, Interventional, and Other

Phase
Not applicable
Study type
Interventional
Enrollment
802
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study 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).

Read the detailed description

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).

Five Internal Medicine Unit and four Units of Neurology will be randomized to the two different strategies of discharge planning (RDP or DDP), based on two different alternating sequences of four periods (each period comprising three months). The randomization will be stratified by type of unit.

Patients at risk of complex discharge, according to the simplified BRASS score, are assigned to the Hospital Unit of Continuity of Care (NOCC) team, using the hospital telematics system. Afterwards, the NOCC team proposes an appropriate discharge planning, considering clinical and social needs.

02

Conditions studied

  • Patient Discharge
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

Inclusion Criteria:

  • 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

No specific exclusion criteria were applied.

04

Study design

Phase
Not applicable
Primary purpose
Other
Allocation
Randomized
Intervention model
Crossover assignment
Masking
None (open label)
Enrollment
802 participants (actual)

Study arms

  • Active comparator
    On Demand Discharge Planning (DDP)

    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)

  • Experimental
    Routine Discharge Planning (RDP)

    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

  • OtherOn Demand Discharge Planning (DDP)

    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.

  • OtherRoutine Discharge Planning (RDP)

    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)

05

What researchers measure

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.

    Time frame: 90 days

Secondary outcomes

  1. Proportion of Long Length of Stay (LLOS)

    Proportion of admissions with long duration of hospitalization (LLOS - Long Length of Stay). The endpoint will be calculated for all hospitalized patients. An admission will be considered as LLOS if its duration will be higher than the 90th specific percentile for Diagnostic Related Group (DRG ) detected at the regional level in Piedmont in 2016.

    Time frame: 150 days

  2. Death within 90 days from discharge

    Proportion of deaths within 90 days of discharge date. The endpoint will be calculated only for patients discharged alive. Death for any cause will be considered as event.

    Time frame: 90 days

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

    Incidence of activations of the NOCC in the periods of adoption of the DDP strategy (only for admissions treated with DDP strategy)

    Time frame: 150 days

  4. Healthcare costs until 90 days from the discharge

    Health care costs charged to the National Health Service (NHS) between the date of admission and 90 days from the date of discharge or death of the patient.

    Time frame: 90 days

06

Study locations

1 site
  • AOU Città della Salute
    Torino, 10100, Italy
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03436940
Lead sponsor
A.O.U. Città della Salute e della Scienza
Responsible party
Daniela Corsi (MD, Director of "SSD Integrazione Ospedale-Territorio", A.O.U. Città della Salute e della Scienza) — Principal investigator
First posted
Feb 19, 2018
Start date
Jun 1, 2018
Primary completion
Oct 12, 2019
Completion
Oct 13, 2019
Last update
Mar 29, 2022

Study contacts

Daniela Corsi, MD
principal investigator · A.O.U. Città della Salute e della Scienza

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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