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OpenTrials
Completed

NCT Number: NCT01422811

Unnecessary, Avoidable Lengths of Stay: a Strategy for Clinician Empowerment and Effectiveness Evaluation

1. Background: In recent years an increasing trend in excessive lengths of stay has been recorded at the Parma University Hospital, compared with regional mean values. Excessive lengths of stay have been demonstrated to constitute not just an economic problem, but also a clinical and public health issue. Since the measures taken at our institution so far have not proven effective, the investigators carried out a literature review, which mostly detected observational studies, restricted to the assessment of the impact of a single intervention. 2. Objectives: This project intends to evaluate the effectiveness of a multifaceted strategy aiming to empower clinicians on the issues associated with excessively long and avoidable hospital stays, and enable them to identify corrective measures (according to the principles of clinical governance). 3. Study design: cluster-randomized, parallel group, open-label, community trial 4. Methods: trained personnel will periodically record causes for excessive lengths of stay in all participating wards using an ad hoc data collection sheet. In the wards randomized to the experimental group, interventions aimed to clinician empowerment - provision of reminders and periodical audits - will be implemented. 5. Expected results: A reduction in the experimental vs. the control arm unnecessary lengths of stay is expected, although the introduced measures will also presumably lead to improvement in the wards where they are not implemented.

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Key information

Conditions

Hospitalization Length of Stay

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

Azienda Ospedaliero-Universitaria di Parma

Parma, 43126, Italy

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • patients present on the participating wards during one of 12 randomly selected index days (one for each month of data collection)

Exclusion criteria

  • patients admitted or discharged on the index days
  • patients with length of stay (interview date - admission date) > 90 days

Treatment and study plan

Multicomponent strategy to reduce avoidable length of stay

Behavioral

The strategy comprises two integrated components:

  • Distribution of two monthly reports, one consisting in the list of patients who, through data collection performed, are classified to be present on the ward although their clinical status is considered compatible with discharge; the other featuring individual length of stay profiles for each physician operating in the intervention arm (information taken from administrative data), allowing comparisons with the rest of the medical staff;
  • Audits performed by professionals of each ward of the intervention arm designed to discuss cases judged to be compatible with discharge. The organization of this work are left to the wards, without any interference from the project team.

No intervention

Other

No interventions (reporting, auditing) are planned; nevertheless control ward physicians know study aims and are informed about their patient's data collection.

Primary outcomes

  1. Percentage of patient-days compatible with discharge

    Time frame: 12 month period [02/2008 - 02/2009] +1 follow up month [02/2010]

Secondary outcomes

  1. Overall length of stay (in days)

    Time frame: 12 month period [02/2008 - 02/2009]

    Overall length of stay = discharge date - admission date

Sponsors and collaborators

Lead sponsor

Azienda Ospedaliero-Universitaria di Parma

Other

Collaborators

  • Regione Emilia-Romagna

Registry information

Important dates

Study start
2008
Primary completion
2009
Study completion
2010
First posted
Aug 24, 2011
Registry last updated
Jul 3, 2018

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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