- ICH GCP
- Registro de ensayos clínicos de EE. UU.
- Ensayo clínico NCT01587105
Improving Care for Children With Complex Needs (I3CN)
Improving Care for Children With Complex Needs (I3CN) Study
Descripción general del estudio
Estado
Condiciones
- Coordinación de Atención
- Medically Complex Children
- Administrador de casos
- Care Manager
- Atención colaborativa
- Manejo de enfermedad
- Patient Care Team or Organization
- Managed Care
- Children With Chronic Conditions
- Children With Special Health Care Needs
- Shared Care Plan
- Patient Care Plan
- Health Care and Resource Utilization
- Adherence to Care
- Functional Status and Productivity
- Calidad de vida relacionada con la salud
- Satisfaction With Care
- Care Coordinator
- Family Experience of Care
- Quality Health Care
Intervención / Tratamiento
Descripción detallada
Children with complex health care needs often lack a comprehensive care plan and access to case management. They are at risk for frequent and prolonged hospitalizations, fragmented care, parental stress/burnout and unsafe care. To address this issue, Seattle Children's Hospital developed the Comprehensive Case Management (CCM) program, which includes access to a special clinic at Seattle Children's with case managers and a health care team that works with parents and community physicians to create care plans for children with complex needs.
The investigators goal is to evaluate whether children who participate in the CCM program have better parent reported access to needed care, timeliness of receiving needed services, more coordinated care, improved health status, and higher parent satisfaction with care compared to children who receive care outside the CCM program. In addition, the investigators will examine whether these children experience decreased annual costs of care, emergency department visits, hospital admissions, and hospital lengths of stay compared to children receiving care outside the program. The investigators also want to understand whether community physicians who have patients enrolled in the CCM program are more satisfied with caring for children with complex medical needs than physicians caring for these children outside the program.
The investigators plan to enroll 650 parents of eligible children into the I3CN study. Three hundred twenty five of these parents will have children enrolled in the CCM program and 325 will have children who continue to receive usual care. Enrolled parents complete a survey every 6 months during the study (5 surveys over 2 ½ years) in order to assess study outcomes including parent perceived. Parent participation in the study will be completed 2 ½ years after enrollment.
When a child enrolls in the CCM program, the child's parent will work together with the CCM team at Seattle Children's to develop a shared care plan for their child. The CCM team includes physicians, nurse practitioners, social workers, nutritionists, and nurse case managers. This plan will include all of the child's routine health care needs in addition to information about what to do when the child gets sick. Community providers will also be asked to review and provide input on the shared care plan. Once the shared care plan is in place, the parent, primary care provider (PCP), and the CCM clinic will follow the standardized processes established by the program and the shared care plan when the child becomes ill.
During the course of the 2 ½ year study, the investigators will analyze our outcomes of interest every 6 months. If the investigators find that children in the CCM the program are experiencing significantly better outcomes than children receiving care outside the program, they will stop the study and open the program to all eligible children.
Tipo de estudio
Inscripción (Actual)
Fase
- No aplica
Contactos y Ubicaciones
Ubicaciones de estudio
-
-
Washington
-
Seattle, Washington, Estados Unidos, 98105
- Seattle Children's Hospital
-
-
Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Descripción
Inclusion Criteria:
- between the ages of 3 months and 18 years,
- have at least three chronic medical conditions requiring active management
- were hospitalized or had an emergency department (ED) visit at SCH within the last year
- their PCP is enrolled in the study
Exclusion Criteria:
- had 2+ visits to Pulmonary, Craniofacial, or Rheumatology within the last year
- had 3+ visits to Nephrology, Gastroenterology and has either Short Gut Syndrome or Crohn's Disease, Endocrinology or Neuromuscular Clinic within the last year
- has had 2+ visits to the Neurodevelopmental clinic and is followed by a NDV doctor
- cancer patient
- transplant recipient
- has cystic fibrosis, muscular dystrophy or sickle cell anemia
- has Down Syndrome and does not have any other medical issues aside from developmental delays
- renal patient on dialysis
- had a hospitalization for > 27 days
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Investigación de servicios de salud
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Ninguno (etiqueta abierta)
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
---|---|
Sin intervención: Control
Grupo de atención habitual
|
|
Experimental: Comprehensive Care Management Service
Care Coordination through the Comprehensive Care Management Service at Seattle Children's Hospital
|
When a child enrolls in the CCM program, the child's parent will work together with the CCM team at Seattle Children's to develop a shared care plan for their child.
This plan will include all of the child's routine health care needs and information about what to do when the child gets sick.
The parent will also have 24 hour access to an on-call CCM nurse.
|
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
---|---|---|
Cost of Care
Periodo de tiempo: Baseline, 12 month, 18 month
|
The investigators will examine whether the children in the CCM group experience decreased annual costs of care.
|
Baseline, 12 month, 18 month
|
Health Care Quality Ranking
Periodo de tiempo: Baseline, 12-months, 18-months
|
For Healthcare Quality Rating, the construct is Parent Satisfaction.
Parents were asked to rate the quality of the health care their child received.
Overall range is 0-100.
Higher values equal a better outcome or more satisfaction.
Sub scales are not combined.
The scale is considered continuous.
|
Baseline, 12-months, 18-months
|
ED Visits Per Child
Periodo de tiempo: Baseline, 12-month, 18-month
|
Baseline, 12-month, 18-month
|
|
Inpatient Admissions Per Child
Periodo de tiempo: Baseline, 12 month, 18 month
|
Baseline, 12 month, 18 month
|
|
Hospital Days Per Child
Periodo de tiempo: Baseline, 12-Month, 18-Month
|
Number of days each participant stayed in the hospital; assessed from hospital administrative discharge data
|
Baseline, 12-Month, 18-Month
|
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
---|---|---|
Physician Satisfaction
Periodo de tiempo: Baseline, 12 Months, 18 months
|
Primary care provider (PCP)'s satisfaction with the care coordination program was measured on a scale of 0-100, where the higher number indicates more satisfaction.
This variable was collected at baseline and 12-months but was dropped from the 18 month follow-up as previous analysis suggested it was not relevant to the stated objective.
|
Baseline, 12 Months, 18 months
|
Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Rita Mangione-Smith, MD, MPH, Seattle Children's Hospital
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio
Finalización primaria (Actual)
Finalización del estudio (Actual)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Estimar)
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Otros números de identificación del estudio
- CCMS
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .