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NCT Number: NCT03436940

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

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).

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Key information

Conditions

Patient Discharge

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

AOU Città della Salute

Torino, 10100, Italy

About this study

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.

Who can participate

Healthy volunteers accepted: No

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

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.

Treatment and study plan

On Demand Discharge Planning (DDP)

Other

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.

Routine Discharge Planning (RDP)

Other

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)

Primary outcomes

  1. Unexpected hospital readmission within 90 days from discharge

    Time frame: 90 days

    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.

Secondary outcomes

  1. Proportion of Long Length of Stay (LLOS)

    Time frame: 150 days

    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.

  2. Death within 90 days from discharge

    Time frame: 90 days

    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.

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

    Time frame: 150 days

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

  4. Healthcare costs until 90 days from the discharge

    Time frame: 90 days

    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.

Sponsors and collaborators

Lead sponsor

A.O.U. Città della Salute e della Scienza

Other

Registry information

Official study title

Comparison Between Two Strategies of Discharge Planning for the Reduction of Short Term Hospital Readmissions: A Cluster Randomized Cross-over Trial

Acronym: PROMENADE

Important dates

Study start
2018
Primary completion
2019
Study completion
2019
First posted
Feb 19, 2018
Registry last updated
Mar 29, 2022

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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