Garnering Effective Telehealth 2 Help Optimize Multidisciplinary Team Engagement (GET2HOME)

The purpose of this study is to determine the effectiveness of the GET2HOME Intervention bundle.

Study Overview

• Status: Completed
• Conditions: Children With Complex Chronic Conditions
• Intervention / Treatment: Behavioral: GET2HOME Intervention

• Study Type: Interventional
• Enrollment (Actual): 638
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Ohio
    • Cincinnati, Ohio, United States, 45229
      • Cincinnati Children's Hospital Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Patients with complex chronic disease based on a Pediatric Medical Complexity Algorithm (PMCA) score of 3 and their families and their primary care providers
• Discharged from pediatric hospital medicine service at our hospital

Exclusion Criteria:

• Patients who live independently without a parent or guardian in the home, including those that live at skilled nursing facilities
• Patients admitted for end of life care
• Patients admitted for suicidal or homicidal ideation
• Patients who previously enrolled in the study
• Patients in county custody

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Standard Hospital-Based Care Coordination; Patients and families randomized to this arm will receive best practice standard of care hospital-based transition planning in the hospital with routine outpatient care team follow-up post-discharge.
Experimental: GET2HOME Intervention; The GET2HOME intervention includes: 1) a pre-discharge telehealth huddle with the family, inpatient team, primary care team, and home care nursing; 2) a visual discharge task tracker (DTT) to monitor progress across care management tasks; and if desired by family and primary care 3) a post-discharge telehealth huddle 2-7 days after discharge with the family, inpatient team, primary care team, and home care nursing	Behavioral: GET2HOME Intervention; Intervention bundle designed to improve discharge effectiveness

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Urgent healthcare reutilization	Yes/no to any: unplanned hospital readmission, ED revisit, or urgent care visit	30-days post-discharge

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Global Quality of Life Scale	Quality of Life assessment for child, caregiver and family; minimum score 0, maximum score 100; higher score means a better outcome	7-, 30-, 60-, and 90-days post-discharge
Return to baseline	Capturing the time it takes to return to a normal routine (family designed measure)	7-, 30-, 60-, and 90-days post-discharge

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Percent of participants with transition process failures	Family-reported challenges with medications, medical supplies, and follow-up	7-days post-discharge
Transition quality	Pediatric Transition Experience Measure (P-TEM) is an 8-item, parent reported measure on a 0-100 scale, in which higher scores reflect better quality	7-days post-discharge
Urgent healthcare reutilization	Yes/no to any: unplanned hospital readmission, ED revisit, or urgent care visit	7-days post-discharge
Medical and non-medical out-of-pocket costs	Family-reported measure of costs	30-days post-discharge
Caregiver time to manage illness post-discharge	Family-reported time measure	30-days post-discharge
Primary care provider transition time burden	Primary care provider reported measure quantifying the amount of time spent on the patients' hospital to home transition	10 days post-discharge

Collaborators and Investigators

• Sponsor: Children's Hospital Medical Center, Cincinnati
• Collaborators: Patient-Centered Outcomes Research Institute

Publications and helpful links

General Publications

• Warniment A, Sauers-Ford H, Brady PW, Beck AF, Callahan SR, Giambra BK, Herzog D, Huang B, Loechtenfeldt A, Loechtenfeldt L, Miller CL, Perez E, Riddle SW, Shah SS, Shepard M, Sucharew HJ, Tegtmeyer K, Thomson JE, Auger KA; GET2HOME Trial Group. Garnering effective telehealth to help optimize multidisciplinary team engagement (GET2HOME) for children with medical complexity: Protocol for a pragmatic randomized control trial. J Hosp Med. 2023 Oct;18(10):877-887. doi: 10.1002/jhm.13192. Epub 2023 Aug 21.

Study record dates

Study Major Dates

• Study Start (Actual): November 1, 2022
• Primary Completion (Actual): September 29, 2025
• Study Completion (Actual): December 31, 2025

Study Registration Dates

• First Submitted: October 3, 2022
• First Submitted That Met QC Criteria: October 4, 2022
• First Posted (Actual): October 5, 2022

Study Record Updates

• Last Update Posted (Actual): February 4, 2026
• Last Update Submitted That Met QC Criteria: February 2, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Chronic Disease
• Other Study ID Numbers: 2022-0511

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
• product manufactured in and exported from the U.S.: No