Comparison Between Two Strategies of Discharge Planning for the Reduction of Short Term Hospital Readmissions (PROMENADE)

Azienda Ospedaliera Città della Salute e della Scienza di Torino

Status: Completed

Conditions: Patient Discharge

Treatments: Other: On Demand Discharge Planning (DDP); Other: Routine Discharge Planning (RDP)

Study type: Interventional

Funder types: Other

Identifiers

NCT03436940

CS2/378/2017

Details and patient eligibility

About

The purpose of this study is to improve discharge planning effectiveness by comparing two strategies [on-Demand Discharge Planning (DDP) vs. Routine Discharge Planning (RDP)], in terms of reduction of hospital readmissions for inpatients classified at intermediate risk of complex discharge using the simplified Blaylock Risk Assessment Screening Score (BRASS).

Full description

The purpose of this study is to improve discharge planning effectiveness by comparing two strategies [on-Demand Discharge Planning (DDP) vs. Routine Discharge Planning (RDP)], in terms of reduction of hospital readmissions for inpatients classified at intermediate risk of complex discharge using the simplified Blaylock Risk Assessment Screening Score (BRASS).

Five Internal Medicine Unit and four Units of Neurology will be randomized to the two different strategies of discharge planning (RDP or DDP), based on two different alternating sequences of four periods (each period comprising three months). The randomization will be stratified by type of unit.

Patients at risk of complex discharge, according to the simplified BRASS score, are assigned to the Hospital Unit of Continuity of Care (NOCC) team, using the hospital telematics system. Afterwards, the NOCC team proposes an appropriate discharge planning, considering clinical and social needs.

Enrollment: 802 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

• Adults patients (age ≥ 18 years);
• Residents in Piedmont, Italy;
• Patients admitted to General Internal Medicine or Neurology Units of Molinette Hospital (Turin)
• Patients with a score in the simplified BRASS between 4 and 6 at admission

No specific exclusion criteria were applied.

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: None (Open label)

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802 participants in 2 patient groups

On Demand Discharge Planning (DDP)

Active Comparator group

Description:

Patients with an intermediate score, according to the simplified Blaylock Risk Assessment Screening Score, are addressed to the NOCC team only in case of a specific request by the unit of hospitalization.

Treatment:

Other: On Demand Discharge Planning (DDP)

Routine Discharge Planning (RDP)

Experimental group

Description:

All patients with an intermediate threshold value of the simplified Blaylock Risk Assessment Screening Score are submitted to discharge planning by the NOCC team (Hospital Unit of Continuity of Care)

Treatment:

Other: Routine Discharge Planning (RDP)