Post-Surgical Based Efforts to Reduce Preventable Readmissions and Optimize Length of Stay (RPM)

Mayo Clinic

Status: Completed

Conditions: Surgery

Treatments: Device: Remote Monitoring

Study type: Interventional

Funder types: Other

Identifiers

NCT04881708

21-000817

Details and patient eligibility

About

The investigators believe that hospital readmissions for intermediate- to high-complexity surgeries can be reduced by remote patient monitoring follow-up post-discharge, which involves daily touchpoints with a clinical nurse, vital sign evaluation and a symptom directed communication escalation process.

Enrollment: 300 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adults (over 18 years of age)
• Undergoing one of the following inpatient elective surgery procedures: abdominal wall reconstruction, bariatrics, hepatectomy, pancreatectomy, aortic surgery, lower extremity bypass, esophagectomy and colectomy at Mayo Clinic Rochester.
• Must be willing to actively work with RPM nurses with vital sign capturing.

Exclusion criteria

• Have uncontrolled mental illness and/or drug or alcohol abuse
• Reside in a long-term care facility
• Are being actively followed by dialysis or transplant services
• Pregnant
• Are being actively treated for cancer, receiving chemo or radiation therapy during the remote monitoring
• Are identified as end-of-life by provider
• Have dementia, cognitive impairment, or physical condition that limits ability to use home remote monitoring equipment independently or interact with remote patient monitoring staff (unless a caregiver commits to assisting daily).

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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300 participants in 2 patient groups

Current Care Group

No Intervention group

Description:

The current care group will receive the standard of care currently in place within the subspecialty practices in the Department of Surgery, Mayo Clinic Rochester. This includes postoperative inpatient care directed by the surgical team, including timing of discharge and follow-up.

Remote Care Group

Active Comparator group

Description:

Patients randomized to the remote monitoring arm will engage in a Connected Care Remote Patient Monitoring (RPM) Complex Care program. RPM Complex Care programs utilize established and standardized equipment, logistics/reverse logistic, engagement methods, and nursing clinical practice. Use of RPM Complex Care programs in this manner, is considered standard practice. Patients will be monitored for 30 days by the Connected Care nursing team as is standard for surgical RPM Complex Care programs.

Treatment:

Device: Remote Monitoring