Garnering Effective Telehealth 2 Help Optimize Multidisciplinary Team Engagement (GET2HOME)

Cincinnati Children's Hospital Medical Center

Status: Completed

Conditions: Children With Complex Chronic Conditions

Treatments: Behavioral: GET2HOME Intervention

Study type: Interventional

Funder types: Other

Identifiers

NCT05568355

2022-0511

Details and patient eligibility

About

The purpose of this study is to determine the effectiveness of the GET2HOME Intervention bundle.

Enrollment: 638 patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients with complex chronic disease based on a Pediatric Medical Complexity Algorithm (PMCA) score of 3 and their families and their primary care providers
• Discharged from pediatric hospital medicine service at our hospital

Exclusion criteria

• Patients who live independently without a parent or guardian in the home, including those that live at skilled nursing facilities
• Patients admitted for end of life care
• Patients admitted for suicidal or homicidal ideation
• Patients who previously enrolled in the study
• Patients in county custody

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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638 participants in 2 patient groups

Standard Hospital-Based Care Coordination

No Intervention group

Description:

Patients and families randomized to this arm will receive best practice standard of care hospital-based transition planning in the hospital with routine outpatient care team follow-up post-discharge.

GET2HOME Intervention

Experimental group

Description:

The GET2HOME intervention includes: 1) a pre-discharge telehealth huddle with the family, inpatient team, primary care team, and home care nursing; 2) a visual discharge task tracker (DTT) to monitor progress across care management tasks; and if desired by family and primary care 3) a post-discharge telehealth huddle 2-7 days after discharge with the family, inpatient team, primary care team, and home care nursing

Treatment:

Behavioral: GET2HOME Intervention