Heart sounds: a pilot randomised trial to determine the feasibility and acceptability of audio recordings to improve discharge communication for cardiology inpatients protocol

Stacey L Schott, Michelle D Dannenberg, Shayne E Dodge, Jesse A Schoonmaker, Molly M Caisse, Paul J Barr, A James O'Malley, Martha L Bruce, Stacey L Schott, Michelle D Dannenberg, Shayne E Dodge, Jesse A Schoonmaker, Molly M Caisse, Paul J Barr, A James O'Malley, Martha L Bruce

Abstract

Introduction: Ineffective hospital discharge communication can significantly impact patient understanding, safety and treatment adherence. This may be especially true for cardiology inpatients who leave the hospital with complex discharge plans delivered in a time-pressured discharge discussion. The goal of this pilot trial was to determine if providing supplemental audio-recorded discharge instructions is feasible and to explore its impact on cardiology patients' ability to understand and self-manage their care .

Methods and analysis: We will conduct a parallel-group, randomised controlled trial in adult cardiology inpatients with balanced blocking by a physician. Patients (n=50) will be randomised to usual care (verbal discussion and written summary) or intervention (usual care, plus audio-recorded discharge discussion provided to patients on a portable electronic recording device). Enrolled patients will complete study assessments immediately prior to the discharge discussion, immediately postdischarge discussion and 1 week after hospital discharge by telephone. Primary outcomes include the proportion of eligible providers and inpatients who agree to take part in the trial, the proportion of inpatients who receive the audio recording in accordance with a fidelity checklist, and the proportion who use the audio recording. We will analyse preliminary data about the impact of audio recording on patient activation, health confidence, provider communication ability, adherence and 30-day readmissions.

Ethics and dissemination: This trial was approved by The Committee for the Protection of Human Subjects (CPHS) at Dartmouth College (CPHS# 00031211). Findings will be disseminated in scientific journals and at meetings.

Trial registration number: NCT03735342.

Protocol version: 1.0.

Keywords: audio recording; cardiology; hospital discharge; self-management; understanding.

Conflict of interest statement

Competing interests: Primary investigator (PI) (SS) and co-investigators (MD, SD, JS, MC, MB and JOM) have no financial or competing interests to disclose. The PI (PJB) has no financial interests to disclose but does lead a research group, OpenRecordings, that studies sharing audio/video recordings with patients, caregivers and clinicians and has developed the online sharing technology offered in this project (http://www.openrecordings.org/orals).

Figures

Figure 1
Figure 1
Consort diagram depicting participant timeline and progression through all phases of the study, including final data analysis.

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