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Reducing Readmissions in High-Risk Ostomates

27. september 2018 oppdatert av: 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.

Studieoversikt

Status

Avsluttet

Forhold

Intervensjon / Behandling

Studietype

Intervensjonell

Registrering (Faktiske)

94

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Forente stater
    • Missouri
      • Saint Louis, Missouri, Forente stater, 63110
        • Washington University School of Medicine

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

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.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Helsetjenesteforskning
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Aktiv komparator: 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
Annen: Pre-operative education (standard of care)
Annen: Home health care visits (standard of care)
Annen: Follow-up post-operative visits
Annen: Patient Data Collection Form
-Form that contains date, area to record number of pouches, and if home health care visit took place.
Annen: 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
Annen: 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.
Eksperimentell: 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
Annen: Pre-operative education (standard of care)
Annen: Home health care visits (standard of care)
Annen: Follow-up post-operative visits
Annen: Patient Data Collection Form
-Form that contains date, area to record number of pouches, and if home health care visit took place.
Annen: 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
Annen: 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.
Annen: Phone call with CWOCN or PA

Hva måler studien?

Primære resultatmål

Resultatmål
Tidsramme
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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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)

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Impact that the early telephone follow-up and evaluation have on the number of office visits
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 30-day clinical visit (approximately 37-52 days after admission)
30-day clinical visit (approximately 37-52 days after admission)

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Washington University School of Medicine

Etterforskere

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

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Hjelpsomme linker

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

1. april 2016

Primær fullføring (Faktiske)

22. august 2018

Studiet fullført (Faktiske)

22. august 2018

Datoer for studieregistrering

Først innsendt

14. januar 2016

Først innsendt som oppfylte QC-kriteriene

14. januar 2016

Først lagt ut (Anslag)

18. januar 2016

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

1. oktober 2018

Siste oppdatering sendt inn som oppfylte QC-kriteriene

27. september 2018

Sist bekreftet

1. september 2018

Mer informasjon

Begreper knyttet til denne studien

Andre studie-ID-numre

  • 201601014

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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