Capturing Readmission Internationally to Prevent Readmission by Safer@Home Group (CURIOS@)

December 1, 2015 updated by: Prabath W.B. Nanayakkara, Amsterdam UMC, location VUmc

Capturing Readmission Internationally to Prevent Readmission by Safer@Home

CURIOS@ is a prospective multi-centre cross-sectional study to investigate readmissions in participating units. The data collected is derived from two clinical episodes: the episode containing the re-admission and the previous admission (index admission).

The main aims are:

Outcomes:

  • Risk factors to predict preventable readmissions in non-surgical patients
  • Percentage of subjectively non-preventable and preventable readmissions from patient, carer, their nurses and their physician's point of view
  • Comparison for risk factors on readmissions throughout Europe
  • Increasing awareness and knowledge for health-care workers on readmissions and its preventability

Study Overview

Status

Unknown

Conditions

Detailed Description

Data will be derived directly from patients, from the clinical notes of the previous admission and records of discharge communication. Also information from treating physicians, nurses and immediate caregivers will be collected. The data set will contain no directly identifiable variables (data will be registered by using a research code for each patient).

Data collection will include: Hospital-related data, patient-related data, health-related data, time-related data, and physician related data. Also patient feedback is requested.

After obtaining written informed consent, the researcher will ask the patient 7 questions about the (preventability of their) readmission. Also the patient will be asked if one of the direct carers can be approached with 2 questions. The carer will most often be a sibling, a good friend or someone from the neighborhood. We will approach the carer in person or by telephone, and only after explicit permission from the patient. Lastly, we will ask a doctor and nurse (responsible for the patient in the first 24 hours of his readmission) similar questions.

Study Type

Observational

Enrollment (Anticipated)

1000

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

  • Denmark
      • Esbjerg, Denmark, 5270 Odense N
        • Hospital of South West Jutland
  • Netherlands
      • Amsterdam, Netherlands, 1105AZ
        • Academic Medical Centre (AMC)
      • Dordrecht, Netherlands, 3300 AK
        • Albert Schweitzer
      • Hoorn, Netherlands, 1624 NP
        • Westfriesgasthuis
      • Venlo, Netherlands, 5912 BL
        • VieCuri Hospital
    • Noord-Holland
      • Amsterdam, Noord-Holland, Netherlands, 1081 HV
        • VU University Medical Centre
  • United Kingdom
      • Bangor, United Kingdom, LL57 2PW
        • Ysbyty Gwynedd Hospital
      • Manchester, United Kingdom, M13 9WL
        • University Hospital of South Manchester

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

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Probability Sample

Study Population

All patients readmitted for at least one night for a medical specialism after any type of admission at any ward in the previous 30 days, with an overnight stay. This could be from any ward, for any procedure (elective/non-elective)

Description

Inclusion criteria:

  • Adult patients aged 18 or above admitted to hospital as unscheduled medical admission for a minimum of a single night following a previous admission within 30 days
  • Index admission can be for any procedure (elective/non-elective)
  • Index admission at any hospital ward (except psychiatry, pediatrics or gynaecology) for a minimum of a single night during the previous 30 days
  • Readmission should be to a medical ward (Medical ward: Cardiology, geriatrics, gastroenterology, hematology, internal medicine, nephrology, neurology, oncology, pulmonary medicine, rheumatology.)
  • If a patient is readmitted more than once within the study period, only the first readmission will be included
  • The port of entry is through an Emergency Department, Acute Medical Unit or any other clinical ward (i.e. department of internal medicine).
  • Patients should all be capable of understanding the study and give written informed consent. They should all be mentally competent.

Exclusion criteria:

  • Patients readmitted electively for procedures, surgery or chemotherapy
  • Patients readmitted for a non-medical specialism (surgery, urology, ent etc..)
  • Patients admitted or readmitted who are pregnant
  • Patients admitted or readmitted aged under 18
  • Patients index or readmission for pediatrics, psychiatry, gynaecology
  • Patients who stayed less than one night during index and readmission
  • Patients who have been admitted to another institution in their index admission (To facilitate timely case identification and ready access to treating physicians, we will only review same-hospital readmissions)
  • A second readmission for the same patient within the study period

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

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percentage of readmissions deemed preventable by patients, their informal carers, nurses and physicians
Time Frame: 1 year
Of all the readmissions in the study, we will look at the readmissions which are deemed potentially preventable (YES or NO) by all partners of care chain. In the end this will give us a percentage of readmissions judged as potentially preventable by all partners of care chain.
1 year

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Causes of preventable readmissions
Time Frame: 1 year

We will ask all partners in the care chain about the causes of the readmissions. These will be categorised:

Disease-related: Natural progress disease, out of control/influence physician or patient - for example: metastasis cancer.

Patient-related: Related to control/influence patient, out of control/influence professionals - for example: a patient who refused extra home care after the index admission.

Human/caregiver-related: Related to the control/influence professionals - for example: poor medication handover after index inclusion.

Organisational: Readmission related to organisational problems - for example: no beds available, transfer from other hospital etc.

Technical: Readmission related to technical defects of materials or equipment - for example: IV-drip home infusion antibiotics broken.
1 year
Risk factors for preventable readmissions
Time Frame: 1 year

For every readmission, we will ask researchers to fill out a dataset with potential risk factors. These are:

  1. General data regarding readmission: i.e. length of stay, time between index admission and readmission.
  2. Patient-related factors: i.e. age, sex, marital status, living situation etc.
  3. Health-related: ie. comorbiditity, frailty score, polypharmacy etc.
  4. Time-related: i.e. Total admissions in previous year
  5. Physician related: i.e. was a discharge letter send?
1 year

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Amsterdam UMC, location VUmc

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.

General Publications

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

January 1, 2016

Primary Completion (Anticipated)

January 1, 2017

Study Completion (Anticipated)

January 1, 2018

Study Registration Dates

First Submitted

November 25, 2015

First Submitted That Met QC Criteria

December 1, 2015

First Posted (Estimate)

December 3, 2015

Study Record Updates

Last Update Posted (Estimate)

December 3, 2015

Last Update Submitted That Met QC Criteria

December 1, 2015

Last Verified

December 1, 2015

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • VUMedicalcenter

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.

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