Rural Hospital-Level Care at Home for Acutely Ill Adults

March 4, 2024 updated by: David Levine, Brigham and Women's Hospital

Hospital-Level Care at Home for Acutely Ill Adults in Rural Settings: A Randomized Controlled Trial

This study examines the implications of providing hospital-level care in rural homes.

Study Overview

Detailed Description

Home hospital is hospital-level care at home for acutely ill patients. In multiple publications mostly in urban environments, home hospital care delivered cost-effective, high-quality, excellent experience care with similar quality and safety as traditional hospital care. Most home hospital models deliver care in urban environments, not in rural environments.

To determine the effect of home hospital care in rural homes, the investigators propose to the following randomized control trial.

Study Type

Interventional

Enrollment (Actual)

160

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

    • Alberta
      • Wetaskiwin, Alberta, Canada, T9A 3N3
        • Wetaskiwin Hospital and Care Centre
    • Illinois
      • Quincy, Illinois, United States, 62301
        • Blessing Health System
    • Kentucky
      • Hazard, Kentucky, United States, 41701
        • Appalachian Regional Healthcare, Inc.

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

16 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

Patient clinical inclusion criteria:

  • >=18 years old
  • Any infectious process (e.g., pneumonia, diverticulitis, cellulitis, complicated urinary tract infection)
  • Heart failure exacerbation
  • Asthma and chronic obstructive pulmonary disease exacerbation
  • Atrial fibrillation with rapid ventricular response
  • Diabetes and its complications
  • Venous thromboembolism
  • Gout exacerbation
  • Chronic kidney disease with volume overload
  • Hypertensive urgency
  • End of life / desires only medical management

Patient environmental inclusion criteria:

  • Lives in a rural area that can be served by the RHH team.
  • Has capacity to consent to study OR can assent to study and has proxy who can consent (see subject enrollment, below)
  • Can identify a potential caregiver who agrees to stay with patient for first 24 hours of admission. Caregiver must be competent to call care team if a problem is evident to her/him. After 24 hours, this caregiver should be available for as-needed spot checks on the patient.

    • This criterion may be waived for highly competent patients at the patient and clinician's discretion.

Patient caregiver inclusion criteria: (not required for patient participation):

  • Age >= 18 years old
  • Has capacity to consent to study
  • Lives within 15 minutes travel time.

Clinician inclusion criteria:

  • The rural home hospital clinical team will be identified by the site PI at each study site prior to the start of the study. The site PI will recruit local RNs and/or EMT-Ps, and attending physicians (MD) to deploy and provide rural home hospital care.
  • Any member of the rural home hospital clinical team (a clinician providing care in the home) who will be participating in research activities, including the screening and recruitment of patients for the rural home hospital intervention and/or providing care to rural patients that enroll in the intervention.

Sites without continuous monitoring will make amendments to the above inclusion criteria

Exclusion Criteria:

  • Patient exclusion clinical criteria:

    • Acute delirium, as determined by the Confusion Assessment Method
    • Cannot establish peripheral access by any means
    • Secondary condition: active non-melanoma/prostate cancer, end-stage renal disease, acute myocardial infarction, acute cerebral vascular accident, acute hemorrhage (unless part of end of life pathway)
    • Primary diagnosis requires multiple or routine administrations of intravenous narcotics for pain control
    • Cannot independently ambulate to bedside commode, unless home-based aides are available
    • As deemed by on-call MD, patient likely to require any of the following procedures that have not already occurred: computed tomography, magnetic resonance imaging, endoscopic procedure, blood transfusion, cardiac stress test, or surgery (unless these can be coordinated with appropriate facilities during the home hospitalization)
    • For pneumonia:

      • Most recent CURB65 > 3: new confusion, BUN > 19mg/dL, respiratory rate>=30/min, systolic blood pressure<90mmHg, Age>=65 (<14% 30-day mortality)15
      • Most recent SMRTCO > 2: systolic blood pressure < 90mmHg (2pts), multilobar CXR involvement (1pt), respiratory rate >= 30/min, heart rate >= 125, new confusion, oxygen saturation <= 90% (<10% chance of intensive respiratory or vasopressor support)16
      • Absence of clear infiltrate on imaging
      • Cavitary lesion on imaging
      • Pulmonary effusion of unknown etiology
      • O2 saturation < 90% despite 5L O2
    • For heart failure:

      • Has a left ventricular assist device
      • GWTG-HF17 (>10% in-hospital mortality) or ADHERE18 (high risk or intermediate risk 1)*
      • Severe pulmonary hypertension
    • For complicated urinary tract infection:

      • Absence of pyuria
      • Most recent qSOFA > 1 (SBP≤100 mmHg, RR≥22, GCS<15 [any AMS]) (if sepsis, >10% mortality)19
    • For other infection

      • Most recent qSOFA > 1 (SBP≤100 mmHg, RR≥22, GCS<15 [any AMS]) (if sepsis, >10% mortality)19
    • For COPD

      • BAP-65 score > 3 (BUN>25, altered mental status, HR>109, age>65) (<13% chance in-hospital mortality): exercise caution
    • For asthma

      o Peak expiratory flow < 50% of normal: exercise caution

    • For diabetes and its complications

      o Requires IV insulin

    • For hypertensive urgency

      • Systolic blood pressure > 190 mmHg
      • Evidence of end-organ damage; for example, acute kidney injury, focal neurologic deficits, myocardial infarction
    • For atrial fibrillation with rapid ventricular response

      • Likely to require cardioversion
      • New atrial fibrillation with rapid ventricular response
      • Unstable blood pressure, respiratory rate, or oxygenation
      • Despite IV beta and/or calcium channel blockade in the emergency department, HR remains > 125 and SBP remains different than baseline
      • Less than 1 hour of time has elapsed with HR < 125 and SBP similar or higher than baseline
    • Home hospital census is full

      • GWTG-HF: AHA Get with the Guidelines: SBP, BUN, Na, Age, HR, Black race, COPD ADHERE: Acute decompensated heart failure national registry: BUN, creatinine, SBP

Patient environmental exclusion criteria:

  • Undomiciled
  • No working heat (October-April), no working air conditioning if forecast > 80°F (June-September), or no running water
  • On methadone requiring daily pickup of medication
  • In police custody
  • Resides in facility that provides on-site medical care (e.g., skilled nursing facility)
  • Domestic violence screen positive

Sites without continuous monitoring will make amendments to the above exclusion criteria

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: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Home Hospital care
Patients receive hospital-level care in their home, as a substitute to traditional hospital care.
Patients receive hospital-level care in their home
Active Comparator: Traditional Hospital care
Patients receive hospital-level care in the hospital.
Patients receive hospital-level care in the hospital.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Total cost, hospitalization
Time Frame: Date of admission to date of discharge, estimated 10 days later
Published as percent change given sensitivity of these data
Date of admission to date of discharge, estimated 10 days later

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Total cost, discharge to 30-days post discharge
Time Frame: Day of discharge to 30 days later
Published as percent change given sensitivity of these data
Day of discharge to 30 days later
Unplanned readmission within 30-days of discharge
Time Frame: Day of discharge to 30 days later
Percentage
Day of discharge to 30 days later
Days at home
Time Frame: Day of discharge to 30 days later
The number of days spent at home from the day of discharge to 30-days later
Day of discharge to 30 days later
Percent of day lying down
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Day of admission to day of discharge, assessed up to 2 months

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Length of stay, days
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
IV medication, days
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Intravenous fluids, days
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Intravenous diuretics, days
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Intravenous antibiotics, days
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Oxygen requirement, days
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Nebulizer treatment, days
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Imaging, %
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Lab orders, #
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
MD sessions, # of notes
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Consultant sessions, # of notes
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
PT/OT sessions, # of notes
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Frequency of disposition, routine, SNF, home health, other
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Follow up with patient's PCP within 14 days, y/n
Time Frame: Up to 30 days from day of discharge, assessed up to 2 months
Exploratory
Up to 30 days from day of discharge, assessed up to 2 months
SNF utilization, days
Time Frame: Up to 30 days from day of discharge, assessed up to 2 months
Exploratory
Up to 30 days from day of discharge, assessed up to 2 months
Home health utilization, days
Time Frame: Up to 30 days from day of discharge, assessed up to 2 months
Exploratory
Up to 30 days from day of discharge, assessed up to 2 months
Unplanned readmission(s) after index, # and y/n + date
Time Frame: Up to 30 days from day of discharge, assessed up to 2 months
Exploratory
Up to 30 days from day of discharge, assessed up to 2 months
ED observation stay(s), # and y/n + date
Time Frame: Up to 30 days from day of discharge, assessed up to 2 months
Exploratory
Up to 30 days from day of discharge, assessed up to 2 months
ED visit(s), # and y/n + date
Time Frame: Up to 30 days from day of discharge, assessed up to 2 months
Exploratory
Up to 30 days from day of discharge, assessed up to 2 months
Fall, y/n
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Delirium, y/n
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
DVT/PE, y/n
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
New pressure ulcer, y/n
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Thrombophlebitis at peripheral IV site, y/n
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Hospital-acquired catheter-associated urinary tract infection, y/n
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Hospital-acquired Clostridium difficile infection, y/n
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Hospital-acquired methicillin resistant staphylococcus aureus infection, y/n
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
New arrhythmia, y/n
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Hypokalemia, y/n
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Acute kidney injury, y/n
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Medication error, y/n
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Unanticipated mortality, y/n
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Loss of consciousness, y/n
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Transfer back to hospital, y/n
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Intervention arm only; Exploratory
Day of admission to day of discharge, assessed up to 2 months
Unplanned mortality during admission
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Unplanned 30-day mortality
Time Frame: Day of discharge to 30-days post discharge, assessed up to 2 months
Exploratory
Day of discharge to 30-days post discharge, assessed up to 2 months
Pain management, mean pain score on a scale from 0-10 where 10 is the worst pain imaginable
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Hours of sleep per day
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Hours of sleep per night
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Hours of activity per day
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Hours of activity per night
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Hours of sitting upright per day
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Hours of sitting upright per night
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Daily steps
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Use of inappropriate medications in the elderly, y/n
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Use of Foley catheter, y/n
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Use of restraints, y/n
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
EuroQol-5D-5L, visual analogue scale, 0-100, where 100 is the best imaginable health today
Time Frame: At admission, at discharge (the day the patient leaves the hospital environment), and at 30 days after discharge, each assessed up to 2 months
Exploratory
At admission, at discharge (the day the patient leaves the hospital environment), and at 30 days after discharge, each assessed up to 2 months
SF-1
Time Frame: At admission, at discharge (the day the patient leaves the hospital environment), and at 30 days after discharge, each assessed up to 2 months
Exploratory; 1-5 Likert scale: Excellent, very good, good, fair poor
At admission, at discharge (the day the patient leaves the hospital environment), and at 30 days after discharge, each assessed up to 2 months
Activities of daily living, score
Time Frame: At admission, at discharge (the day the patient leaves the hospital environment), and at 30 days after discharge, each assessed up to 2 months
Exploratory
At admission, at discharge (the day the patient leaves the hospital environment), and at 30 days after discharge, each assessed up to 2 months
Instrumental activities of daily living, score
Time Frame: At admission, at discharge (the day the patient leaves the hospital environment), and at 30 days after discharge, each assessed up to 2 months
Exploratory
At admission, at discharge (the day the patient leaves the hospital environment), and at 30 days after discharge, each assessed up to 2 months
Patient health questionnaire-2, score
Time Frame: At admission, at discharge (the day the patient leaves the hospital environment), and at 30 days after discharge, each assessed up to 2 months
Exploratory
At admission, at discharge (the day the patient leaves the hospital environment), and at 30 days after discharge, each assessed up to 2 months
PROMIS Emotional Support Short Form 4a, score
Time Frame: At admission, at discharge (the day the patient leaves the hospital environment), and at 30 days after discharge, each assessed up to 2 months
Exploratory; I have someone who will listen to me when I need to talk I have someone to confide in or talk to about myself or my problems I have someone who makes me feel appreciated I have someone to talk with when I have a bad day Scale for each: never, rarely, sometimes, usually, always
At admission, at discharge (the day the patient leaves the hospital environment), and at 30 days after discharge, each assessed up to 2 months
Picker Experience Questionnaire -15, score, measured 0-15, where 15 is the best patient experience
Time Frame: Within 30 days after discharge, assessed up to 2 months
Exploratory
Within 30 days after discharge, assessed up to 2 months
Global satisfaction with care, score, 0-10, where 10 is the best global satisfaction
Time Frame: Within 30 days after discharge, assessed up to 2 months
Exploratory
Within 30 days after discharge, assessed up to 2 months
Recommend care, score, 0-10, where 10 is the best recommendation possible
Time Frame: Within 30 days after discharge, assessed up to 2 months
Exploratory
Within 30 days after discharge, assessed up to 2 months
Qualitative interview
Time Frame: Day of discharge to 30 days after discharge, assessed up to 2 months
Exploratory
Day of discharge to 30 days after discharge, assessed up to 2 months
Caregiver burden (Zarit), 0-48, where 48 indicates the worst possible caregiver burden
Time Frame: Day of admission and within 30 days after discharge, assessed up to 2 months
Exploratory
Day of admission and within 30 days after discharge, assessed up to 2 months
Number of RN visits, in-person
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Number of RN visits, virtual
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Number of RN visits, total
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
RN travel time
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Failed connectivity, %
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Number of "on call" MD interactions (video or phone)
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Duration of 1st RN visit
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
Duration of subsequent RN visit, in-person
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Duration of subsequent RN visit, virtual
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Other metrics captured on the clinician process survey and nursing visit form
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Insufficient handoff
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Documentation error
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Equipment malfunction
Time Frame: Day of admission to day of discharge, assessed up to 2 months
Exploratory
Day of admission to day of discharge, assessed up to 2 months
Age
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
Gender
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
Race/ethnicity
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
Primary language
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
Health insurance states, public/private/none
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
BMI
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
Comorbidities, type and #
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
Partner status
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
Education
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
Zip code
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
Employment
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
Smoking status
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
Medications used as outpatient, #
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
DNR/I code status
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
Lives alone
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
Home health aide prior to admission
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
Elective and urgent admissions in the previous year, #
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
ED visits in the previous 6 months, #
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
Interqual disease-specific leveling
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
PRISMA-7
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
Eight-item Interview to Differentiate Aging and Dementia
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
Would you be surprised if this patient died in the next year?
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
BRIEF health literacy screening tool
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
Readmission risk score on discharge (HOSPITAL)
Time Frame: Day of discharge, assessed up to 2 months
Exploratory
Day of discharge, assessed up to 2 months
Admitting diagnosis
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
Admission source
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
COVID case count on day of admission
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
Degree of rurality
Time Frame: Day of admission, assessed up to 2 months
Exploratory
Day of admission, assessed up to 2 months
[intervention arm only] RHH admission, daily care, and discharge processes accomplished
Time Frame: Twice a week, day of enrollment to day of final discharge, assessed up to 2 months
Exploratory
Twice a week, day of enrollment to day of final discharge, assessed up to 2 months
[intervention arm only] Perceived acceptability of RHH care
Time Frame: Day of discharge to 30 days postdischarge, assessed up to 2 months
Exploratory
Day of discharge to 30 days postdischarge, assessed up to 2 months
[intervention arm only] Perceived safety, quality of care, caregiver burden
Time Frame: Day of discharge to 30 days, assessed up to 2 months
Exploratory
Day of discharge to 30 days, assessed up to 2 months
Qualitative interviews
Time Frame: Day of enrollment to day of final discharge, assessed up to 4 months
Interviews with patients, caregivers, and rural home hospital clinicians.
Day of enrollment to day of final discharge, assessed up to 4 months

Collaborators and Investigators

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

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 (Actual)

February 16, 2022

Primary Completion (Actual)

December 16, 2023

Study Completion (Actual)

January 17, 2024

Study Registration Dates

First Submitted

October 25, 2021

First Submitted That Met QC Criteria

February 22, 2022

First Posted (Actual)

February 25, 2022

Study Record Updates

Last Update Posted (Estimated)

March 6, 2024

Last Update Submitted That Met QC Criteria

March 4, 2024

Last Verified

March 1, 2024

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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