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Collaborative Healthcare Professionals Approach in Monitoring of Patient Centered Outcomes Through Pathways (CHAMP-Path)

4. april 2017 opdateret af: Majed Aljeraisy

A Pragmatic Randomized Controlled Trial of Patient-Centered Integrated Clinical Pathways Based Versus Usual Care in an Academic Center: National Guard Health Affairs Western Region Experience

The aim of this study is to determine if by providing a collaborative, integrated pathway-based healthcare compared to the usual healthcare, whether or not this would be superior in reducing the length of hospital stay across five high frequency /high risk medical diagnoses: Acute Venous Thromboembolism, Acute Kidney Injury, Community Acquired Pneumonia, Adult Left Ventricular Heart Failure, and Asthma.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This study is a pragmatic randomized controlled trial. To date, there is a scarcity of randomized controlled trials looking at pathway-based, patient-centered healthcare versus usual care in several high-risk or high volume diagnoses that account for the vast majority of hospitalizations in medical settings.

In this study, the pathway care intervention is a collaborative effort that involves healthcare professionals from multiple departments, including pharmacists, health educators, nurses, social workers, nutritionists, and quality management.

For patients allocated to the usual care, these healthcare professionals will deliver standardized care when consulted. For pathway care patients, this collaborative healthcare will be default.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

341

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Saudi Arabien
    • Makkah
      • Jeddah, Makkah, Saudi Arabien, 21423
        • King Khalid National Guard Hospital

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

14 år og ældre (Barn, Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

  1. Inclusion Criteria (Overall Criteria):

    • One principle diagnosis
    • Hemodynamic Stability

  2. Inclusion Criteria (Specific to each Diagnosis):

    Acute Venous Thromboembolism:

    • New onset / in-patient

    Acute Kidney Injury:

    • Patients with increased serum creatinine of more than 50% from baseline

    Community Acquired Pneumonia:

    • Age limit

    Adult Left Ventricular Heart Failure:

    • Age limit

    Asthma

    • Acute exacerbation of Asthma

  3. Exclusion Criteria (Overall Criteria):

    • Intensive Care Unit (ICU) patients
    • Pregnancy
  4. Exclusion Criteria (Specific to each Diagnosis):

Acute Venous Thromboembolism:

  • Hemodynamic instability (Systolic Blood Pressure (SBP) less than 90 mmHg or massive Pulmonary Embolism (PE)
  • PE patients with an sPESI Score ≥ 1

Acute Kidney Injury:

  • Critical care patients (ICU, Coronary Care Unit, burn units)
  • Stage 4 and 5 chronic kidney diseases
  • Kidney allograft recipients
  • Obstructive uropathy
  • Glomerulonephritis
  • Interstitial nephritis

Community Acquired Pneumonia:

  • Intensive Care Unit (ICU) patients
  • Pregnancy

Adult Left Ventricular Heart Failure:

  • All non-cardiogenic pulmonary edema
  • Patients requiring Inotropic agents

Asthma

  • Patients with Chronic Obstructive Pulmonary Disease (COPD) and Bronchiectasis
  • Severe Asthma (Peak Expiratory Flow Rate (PEFR) less than 40 percent)

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Sundhedstjenesteforskning
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Patients on Pathway Care
Andet: Pathway-Based Care
Patients who are randomly allocated to Pathway Care will be treated by the Pathway Clinical Teaching Unit as well as other collaborative healthcare professionals (pharmacists, nurses, health educators, nutritionists, and social workers). The Pathway Care physicians will have access to the Clinical Care Plan on the QuadraMed, which is a detailed, organized, day-to-day treatment plan that includes pre-set orders and medications. Physicians for the patients on Usual Care will not have access to this information, and the collaborative healthcare will only be provided upon consultation.
Ingen indgriben: Patients on Usual Care

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Tidsramme
Decrease in length of hospital stay by two days
Tidsramme: During hospitalization period of 7 to 10 days
During hospitalization period of 7 to 10 days

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
30-Day Rehospitalization
Tidsramme: After discharge up to 30 days
To determine the effect of the pathway-based care versus usual care on 30-day rehospitalization rates for the same diagnosis
After discharge up to 30 days
Determinants of the Length of Stay
Tidsramme: Upon admission until discharge
Upon admission until discharge
Pathway Care Specific Clinical Outcomes
Tidsramme: Upon admission until discharge
For pathway care, there are specific targeted outcomes that ought to be met.
Upon admission until discharge

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Majed Aljeraisy

Efterforskere

  • Ledende efterforsker: Mujtaba Quadri, MD, National Guard Health Affairs
  • Ledende efterforsker: Sherine Esmail, PharmD, National Guard Health Affairs
  • Ledende efterforsker: Saliman Karsou, MD, National Guard Health Affairs
  • Ledende efterforsker: Abdulhameed Gasim, MD, National Guard Health Affairs
  • Ledende efterforsker: Zeyad Zahrani, MD, National Guard Health Affairs
  • Ledende efterforsker: Majed Al Jeraisy, PharmD, King Abdullah International Medical Research Center

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. marts 2012

Primær færdiggørelse (Faktiske)

1. marts 2016

Studieafslutning (Faktiske)

1. marts 2016

Datoer for studieregistrering

Først indsendt

18. marts 2012

Først indsendt, der opfyldte QC-kriterier

22. marts 2012

Først opslået (Skøn)

23. marts 2012

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

5. april 2017

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

4. april 2017

Sidst verificeret

1. april 2017

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • RC 10/134/J

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med Hjertefejl

Kliniske forsøg med Pathway-Based Care

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Sponsorer og samarbejdspartnere

Medicinske tilstande

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Betingelser

Sjældne sygdomme

Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

Placeringer

Abonner