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Reducing Readmissions in High-Risk Ostomates

27 septembre 2018 mis à jour par: Washington University School of Medicine
Preventing complications and readmission after ostomy surgery will decrease the cost of healthcare, improve patient safety, reduce the cost of durable medical equipment required by ostomates, ensure continued specialized care is available, and potentially improve both short and long-term quality of life (QOL) for patients by reducing morbidity and mortality associated with ostomy surgery. The purpose of this study is to measure the effectiveness of patient centered interventions/care pathways and to determine the impact on healthcare utilization, 30-day hospital readmissions, and QOL.

Aperçu de l'étude

Statut

Résilié

Les conditions

Intervention / Traitement

Type d'étude

Interventionnel

Inscription (Réel)

94

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

  • États-Unis
    • Missouri
      • Saint Louis, Missouri, États-Unis, 63110
        • Washington University School of Medicine

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

  • Scheduled to undergo surgery that will result in the creation of an ileostomy.
  • Agreed to receive home healthcare.
  • At least 18 years of age.
  • Speaks English.
  • Has access to telephone.
  • Able to understand and willing to sign an IRB-approved written informed consent document.

Exclusion Criteria:

-Unwilling or unable to receive home health care.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Recherche sur les services de santé
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Comparateur actif: Group A: Standard of care
  • Standard of care pre-operative education
  • Standard of care home health visits
  • Standard of care follow-up post-operative visits with surgeon and CWOCN

  • At 30-days post hospital discharge, the participant will:

    • See the physician
    • Turn in Patient Data Collection Form
    • Turn in Healthcare Utilization Form
    • Complete The City of Hope QOL Survey for Ostomy Patients
    • Ostomy assessment with a CWOCN, including photo of ostomy site
Autre: Pre-operative education (standard of care)
Autre: Home health care visits (standard of care)
Autre: Follow-up post-operative visits
Autre: Patient Data Collection Form
-Form that contains date, area to record number of pouches, and if home health care visit took place.
Autre: Healthcare Utilization Form
  • Form for patient to record if they visited an emergency room or urgent care or if they were hospitalized
  • Form allows patient to record reason for visit and date of visit
Autre: The City of Hope QOL Survey for Ostomy Patients
  • Consists of 47 questions asking various physical, psychological, sexual, work-related, and demographic questions.
  • Additional 34 questions on how the ostomy affects quality of life. Answers range from 0=not at all to 10=severe problem.
Expérimental: Group B: Phone call
  • Standard of care pre-operative education
  • Standard of care home health visits
  • Standard of care follow-up post-operative visits with surgeon and CWOCN
  • Telephone call 48-72 hours post-discharge from CWOCN/PA to evaluate tolerability to foods/fluids, activity level, screen for red-flags, review/assess for medication, reviewing pouching of ostomy, review patient's ability to obtain supplies, provide continued education, discuss proper use of durable medical equipment/frequency of pouch changes, and complete Patient Assessment Form.

  • At 30-days post hospital discharge, the participant will:

    • See the physician
    • Turn in Patient Data Collection Form
    • Turn in Healthcare Utilization Form
    • Complete The City of Hope QOL Survey for Ostomy Patients
    • Ostomy assessment with a CWOCN, including photo of ostomy site
Autre: Pre-operative education (standard of care)
Autre: Home health care visits (standard of care)
Autre: Follow-up post-operative visits
Autre: Patient Data Collection Form
-Form that contains date, area to record number of pouches, and if home health care visit took place.
Autre: Healthcare Utilization Form
  • Form for patient to record if they visited an emergency room or urgent care or if they were hospitalized
  • Form allows patient to record reason for visit and date of visit
Autre: The City of Hope QOL Survey for Ostomy Patients
  • Consists of 47 questions asking various physical, psychological, sexual, work-related, and demographic questions.
  • Additional 34 questions on how the ostomy affects quality of life. Answers range from 0=not at all to 10=severe problem.
Autre: Phone call with CWOCN or PA

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Délai
Impact of early implementation of post-operative assessment by Certified Wound Ostomy Continence Nurse (CWOCN) or physician's assistant (PA) via follow-up telephone call on health care utilization as measured by number of emergency room visits
Délai: Within the first 30 days after hospital charge (up to approximately 37 days)
Within the first 30 days after hospital charge (up to approximately 37 days)
Impact of early implementation of post-operative assessment by CWOCN or PA via follow-up telephone call on health care utilization as measured by number of hospitalizations
Délai: Within the first 30 days after hospital charge (up to approximately 37 days)
Within the first 30 days after hospital charge (up to approximately 37 days)
Impact of early implementation of post-operative assessment by CWOCN or PA via follow-up telephone call on health care utilization as measured by number of urgent care visits
Délai: Within the first 30 days after hospital charge (up to approximately 37 days)
Within the first 30 days after hospital charge (up to approximately 37 days)

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Impact that the early telephone follow-up and evaluation have on the number of office visits
Délai: First 30 days after hospital discharge (approximately 37-52 days after admission)
First 30 days after hospital discharge (approximately 37-52 days after admission)
impact that the early telephone follow-up and evaluation have on the number of phone calls to the office
Délai: First 30 days after hospital discharge (approximately 37-52 days after admission)
First 30 days after hospital discharge (approximately 37-52 days after admission)
Impact that the early telephone follow-up and evaluation have on durable medical equipment (DME) usage
Délai: 30-day CWOCN visit (approximately 37-52 days after admission)
30-day CWOCN visit (approximately 37-52 days after admission)
Impact that the early telephone follow-up and evaluation have on peristomal skin irritation DET score
Délai: 30-day CWOCN visit (approximately 37-52 days after admission)
-PeriPeristomal Skin Assessment/DET score based on discoloration, severity of discoloration, erosion, severity of erosion, tissue overgrowth, and severity of tissue overgrowth
30-day CWOCN visit (approximately 37-52 days after admission)
Impact that the early telephone follow-up and evaluation have on the scores of QOL (quality of life) questionnaire
Délai: 30-day clinical visit (approximately 37-52 days after admission)
30-day clinical visit (approximately 37-52 days after admission)

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Washington University School of Medicine

Les enquêteurs

  • Chercheur principal: Steven R Hunt, M.D., Washington University School of Medicine

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Liens utiles

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

1 avril 2016

Achèvement primaire (Réel)

22 août 2018

Achèvement de l'étude (Réel)

22 août 2018

Dates d'inscription aux études

Première soumission

14 janvier 2016

Première soumission répondant aux critères de contrôle qualité

14 janvier 2016

Première publication (Estimation)

18 janvier 2016

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

1 octobre 2018

Dernière mise à jour soumise répondant aux critères de contrôle qualité

27 septembre 2018

Dernière vérification

1 septembre 2018

Plus d'information

Termes liés à cette étude

Autres numéros d'identification d'étude

  • 201601014

Plan pour les données individuelles des participants (IPD)

Prévoyez-vous de partager les données individuelles des participants (DPI) ?

NON

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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