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

Majed Aljeraisy

Status: Completed

Conditions: Venous Thromboembolism; Asthma; Acute Kidney Injury; Heart Failure; Community Acquired Pneumonia

Treatments: Other: Pathway-Based Care

Study type: Interventional

Funder types: Other

Identifiers

NCT01561885

RC 10/134/J

Details and patient eligibility

About

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.

Full description

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.

Enrollment: 341 patients

Sex: All

Ages: 14+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

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)

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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341 participants in 2 patient groups

Patients on Pathway Care

Active Comparator group

Treatment:

Other: Pathway-Based Care

Patients on Usual Care

No Intervention group