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HEARt Sounds: Audio Recordings to Improve Discharge Communication for Cardiology Inpatients

Dartmouth Health logo

Dartmouth Health

Status

Completed

Conditions

Cardiovascular Disease

Treatments

Other: Audio Recording

Study type

Interventional

Funder types

Other

Identifiers

Details and patient eligibility

About

Ineffective hospital discharge communication can significantly impact patient understanding, safety, and treatment adherence. This is especially true for cardiology patients, who leave the hospital with complex discharge plans, a multitude of high-risk medications, post-procedural care instructions and recommendations for drastic lifestyle changes, all delivered in a time-pressured discharge discussion. The goal of this pilot trial is to determine if it is possible to use audio recordings to supplement usual discharge communication to improve cardiology patients' ability to understand and self-manage care after leaving the hospital.

Full description

The study objective is to assess the feasibility and acceptability of providing audio recorded discharge instructions to patients discharged from an inpatient cardiology service using a two-arm randomized controlled design. Specifically, this pilot study aims to: 1) Determine whether providing audio recorded discharge instructions as a supplemental discharge communication tool is feasible for cardiology providers and patients to use during the inpatient discharge discussion, 2) Determine whether it is acceptable for patients and families to use audio recorded discharge instructions after hospital discharge to self-manage care, and 3) Explore the impact of audio recording on patients' understanding of discharge instructions, ability to self-manage care and ability to adhere to prescribed medications.

On the day of discharge, enrolled patients will be randomized to a usual care arm, which includes bedside discussion and review of written discharge instructions with the discharging provider, or to an intervention arm, which includes bedside discussion and review of written discharge instructions with the discharging provider and an audio recording of that bedside discharge discussion using block randomization at the provider level. All participants randomized to the intervention arm will receive a portable, electronic recording device with audio playback that contains a recording of the bedside discharge discussion, and will also have the option to record the discharge discussion on a smartphone or receive access to the recording online, via the Open Recording Automated Logging System (ORALS). The hypothesis is providing audio recordings of discharge instructions will be feasible and acceptable to cardiology patients and providers.

One week after discharge, all enrolled patients (both arms) will be contacted via telephone to complete an interview about the use of written discharge instructions and a survey about understanding of discharge instructions, confidence and ability to self-manage care, and medication adherence. In addition, patients in the intervention arm will be interviewed about how the audio recording of the discharge discussion was used.

Enrollment

57 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • 18 years of age or older
  • Cardiology inpatients
  • Comfortable reading and writing in English
  • Willing to have discharge conversation recorded

Exclusion criteria

  • Patients who are unable or unwilling to provide written informed consent
  • Diagnosis of dementia, schizophrenia and other psychotic disorders
  • Have a substance-abuse disorder
  • Severe uncorrected vision or hearing problems
  • Currently living in skilled nursing facility or hospice
  • Planned discharge to a structured facility (e.g., skilled nursing facility, intermediate care facility, hospice)

Trial design

Primary purpose

Health Services Research

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Single Blind

57 participants in 2 patient groups

Audio Recording
Experimental group
Description:
Participants receive a verbal discharge discussion with a provider, written discharge instructions and a re-playable audio recording of the discharge discussion with the discharging provider.
Treatment:
Other: Audio Recording
Usual care
No Intervention group
Description:
Participants receive a verbal discharge discussion with a provider and written discharge instructions.

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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