- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01088945
Safe Passages: Ensuring Quality Transitions From NICU (Neonatal Intensive Care Unit) to Ambulatory Care
July 24, 2015 updated by: Virginia Moyer
Safe Passages: Ensuring Quality Transitions From NICU to Ambulatory Care
Infants born prematurely or with complex congenital abnormalities are surviving to discharge in growing numbers and often require significant monitoring and coordination of care in the ambulatory setting.
The specific aims of this project are to determine the effectiveness of a redesigned discharge process that includes a Health Coach and an expanded discharge binder to improve health outcomes in the post discharge follow-up period as compared with usual care.
The outcomes to be evaluated include the occurrence of adverse events in the post-discharge period, quality of follow up care, and caregiver satisfaction with the process.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
Infants born prematurely or with complex congenital abnormalities are surviving to discharge in growing numbers and often require significant monitoring and coordination of care in the ambulatory setting.
These complicated infants have spent all of their lives in the hospital setting, and are strangers in their own homes.
Although the transition of the fragile child from intensive care specialist to the ambulatory care provider begins at hospital discharge, it is incomplete until the child receives appropriate outpatient follow-up with a primary care pediatrician.
Over this prolonged time period, the child is especially vulnerable to errors related to breakdowns in care coordination and communication because the responsibility for the patient's care is often not clearly specified.
Our team of investigators has recently completed a Health Care Failure Modes and Effects Analysis (HFMEA) of the transition from neonatal intensive care to the ambulatory environment.
We will expand upon the Care Transitions Intervention developed by Coleman et al that addressed the problems of older adults who were discharged from hospital to home.
In this model, advanced practice nurses, trained as coaches, taught patients and families to coordinate care for themselves, fostering independence.
We will include the use of a personal health record, to include specific instructions to recognize and self-manage the most common problems in this population and we will use information technology (IT) to enhance communication with families and with community providers, in particular the primary care provider.
Having identified that lack of knowledge and skills on the part of community providers about how to manage these infants as an important risk point, we will add to the Coleman intervention by providing "just-in-time" information to the primary care providers to enhance their knowledge and skill in managing the common problems of neonatal nursery graduates, provided electronically via the Texas Children's Hospital (TCH) clinical decision support program.
Study Type
Interventional
Enrollment (Actual)
229
Phase
- Phase 3
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Texas
-
Houston, Texas, United States, 77030
- Texas Children's Hospital
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Infant hospitalized since birth
- Anticipated total length of stay at least 2 weeks
- Speaks English or Spanish
- Planned follow up physician within the hospital's system
Exclusion Criteria
- follow up physician outside of hospital system
- child in protective custody
- child not anticipated to survive
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Enhanced Discharge Process
Caregivers of these infants will receive individual coaching in order to enhance their understanding of their infant's problems and enhance their knowledge and skills to care for their fragile infants.
|
Health Coaching prior to discharge, with an enhanced discharge binder to reinforce the teaching of the Health Coach
|
Active Comparator: Standard Discharge Process
These infants will receive the hospital's current standard of care for the discharge of fragile infants from the NICU.
|
Health Coaching prior to discharge, with an enhanced discharge binder to reinforce the teaching of the Health Coach
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
adverse outcomes in first 30 days after discharge from NICU
Time Frame: 30 days
|
unplanned ER visits, Unplanned readmissions, deaths, missed appointments
|
30 days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
adherence to recommended practices for care of the fragile newborn
Time Frame: 6 months
|
adherence by primary care physicians to recommended practices for management of the fragile NICU graduate
|
6 months
|
Caregiver assessment of the discharge process
Time Frame: 2-3 and 30 days after discharge
|
Using a validated measure, the CTM-Neo, caregivers will be interviewed both shortly after discharge and at 30 days to determine satisfaction with the transition from hospital to home.
|
2-3 and 30 days after discharge
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Virginia A Moyer, MD, MPH, Baylor College of Medicine
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
March 1, 2010
Primary Completion (Actual)
September 1, 2011
Study Completion (Actual)
September 1, 2011
Study Registration Dates
First Submitted
March 10, 2010
First Submitted That Met QC Criteria
March 17, 2010
First Posted (Estimate)
March 18, 2010
Study Record Updates
Last Update Posted (Estimate)
July 27, 2015
Last Update Submitted That Met QC Criteria
July 24, 2015
Last Verified
July 1, 2015
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- H-26059
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Infant, Premature, Diseases
-
University of MiamiPontificia Universidad Catolica de ChileTerminated
-
Aydin Adnan Menderes UniversityCompletedNursing Caries | Infant Development | Premature Infant Disease | Patient ComfortTurkey
-
University of VirginiaRecruitingDevelopment, Infant | Premature Infant DiseaseUnited States
-
Johnson & Johnson Pharmaceutical Research & Development...TerminatedInfant, Premature | Infant, Newborn
-
Istituto Giannina GasliniEubrainRecruiting
-
Sun Yat-sen UniversityRecruitingPremature Infant DiseaseChina
-
NICHD Neonatal Research NetworkNational Center for Research Resources (NCRR)CompletedSepsis | Infant, Small for Gestational Age | Infant, Premature | Infant, Low Birth Weight | Infant, NewbornUnited States
-
IRCCS Azienda Ospedaliero-Universitaria di BolognaCompletedPreterm Birth | Cerebral Autoregulation | Premature Infant DiseaseItaly
-
Instituto Nacional de Perinatologia Isidro Espinosa...UnknownImmune System Diseases | Premature Infant Disease | Immunoglobulin DeficiencyMexico
-
Universidad de LeónCompletedPremature Birth | Premature Infant | Massage | Preterm Infant
Clinical Trials on Enhanced Discharge process
-
University of California, DavisCompleted
-
Agency for Healthcare Research and Quality (AHRQ)University of Illinois at ChicagoCompletedInterprofessional Relations | Information DisseminationUnited States
-
Dana-Farber Cancer InstituteNational Cancer Institute (NCI)CompletedGynecologic Cancer | Gastrointestinal CancerUnited States
-
University of MontanaProvidence St. Patrick Hospital, Missoula MontanaCompletedAll Causes Hospital Admissions
-
VA Office of Research and DevelopmentCompletedSurgery | Cholecystectomy, Laparoscopic | Arthroplasty, Replacement, Hip | Prostatectomy | Endarterectomy, CarotidUnited States
-
AltaMed Health Services CorporationNational Institute on Aging (NIA); University of Southern CaliforniaRecruitingPatient ReadmissionUnited States
-
Rush University Medical CenterCompletedPatient Discharge | Patient AdmissionUnited States
-
M.D. Anderson Cancer CenterAmerican Society of Colon and Rectal SurgeonsCompletedColorectal CancerUnited States
-
The University of Hong KongRecruiting
-
New York UniversityCompletedSubstance Use DisordersUnited States