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NCT Number: NCT07032818

Adapted Hospital Discharge Intervention: the CONNECT Pilot

Hospital discharge is a dangerous time for patients: one in five will suffer an adverse event, such as a medication error, and nearly 25% will be readmitted within 30 days. This time is even more dangerous for patients with who face communication barriers, including those with non-English language preference (NELP), low health literacy, and the elderly.

The investigators will pilot a post-discharge educational intervention to reinforce written discharge instructions (known as the After Visit Summary or AVS) using a randomized controlled trial design (2:1 intervention: control). The control group will receive current standard of care discharge education which includes a nurse reviewing their AVS and an automated call in English that allows patients to numerically select types of problems/questions that are then escalated to a nurse who should return their call within a few days. The intervention group will receive the standard of care discharge education with the AVS and an additional post-discharge educational call delivered by a registered nurse or other qualified health professional with the option to have written instructions professionally translated and sent via MyChart message--if available in their preferred language.

Recruiting

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Boston Medical Center

Boston, Massachusetts, 02118, United States

Location status: Recruiting

Location contact

Kirsten Austad, MD PhD

CONTACT

617-414-2050

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Registered language in Epic (written or spoken) is Spanish, Haitian Creole, Portuguese, Cape Verdean, or Vietnamese
  • Admitted to medicine team at Boston Medical Center (BMC)
  • Being discharged home (to the community)

Exclusion criteria

  • On airborne infections precautions at time of recruitment
  • On C diff precautions at time of recruitment
  • On suicide precautions at time of recruitment
  • Nurse report of participant displaying cognitive impairment, ongoing delirium, or aggression
  • Discharge observed during a prior admission

Treatment and study plan

Additional post discharge phone call

Other

24-72 hours after hospital discharge, a nurse will call participants to review the written After Visit Summary (AVS) given at discharge, including primary diagnosis, self-care instructions, emergency plan, medication changes, how and why to take medication, and scheduled follow up. These phone calls will take on average 10-15 minutes.

Primary outcomes

  1. Retention success by linguistic group

    Time frame: 12 months

    Number of enrolled participants who completed all study assessments stratified by linguistic group.

  2. Fidelity to the intervention

    Time frame: 12 months

    The number of scheduled educations calls that were completed for participants in the intervention arm based on nursing documentation in Epic.

Secondary outcomes

  1. Acceptability of the intervention

    Time frame: 12 months

    The Acceptability of Intervention Measure (AIM) will be completed by participants in the intervention arm to assess acceptability. It has four questions with 5 Likert responses where 1 = Completely disagree, 2 = Disagree, 3 = Neither agree nor disagree, 4 = Agree, 5 = Completely agree, The range of scores from 4 to 20 with higher scores indicating greater acceptability.

  2. Feasibility of the intervention

    Time frame: 12 months

    Feasibility will be assessed by the number of participants in the intervention arm whose educational call was language concordant based on nursing documentation in Epic.

  3. Patient Understanding of Discharge Instruction (UDI) Scale

    Time frame: 12 months

    Assessed by a composite score of six key domains of discharge instructions (primary diagnosis, self-care instructions, return precautions, medication changes, medication indications, follow-up) as determined by physician adjudicators (1=poor, 4 = near perfect). Higher scores demonstrate better understanding.

Study contacts

Contact information is provided by the study sponsor or research team.

Khushbu Patel, MA

CONTACT

[email protected]

617 414-6227

Kirsten Austad, MD MPH

CONTACT

[email protected]

617 414-2050

Sponsors and collaborators

Lead sponsor

Boston Medical Center

Other

Collaborators

  • National Institute on Minority Health and Health Disparities (NIMHD)

Registry information

Official study title

Communication Outreach for Navigation and Needs-based Care Transitions (CONNECT): A Pilot Randomized Controlled Trial

Acronym: CONNECT

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Jun 24, 2025
Registry last updated
Jan 20, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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