Practical Alternative to Hospitalization (PATH)

University of Pennsylvania

Status: Completed

Conditions: Emergency Department; Health Care Utilization; Health, Subjective

Treatments: Other: PATH Intervention

Study type: Interventional

Funder types: Other

Identifiers

NCT04639102

844436

Details and patient eligibility

About

The investigators test the PATH program to evaluate whether the program allows patients to spend more days at home in comparison to patients who receive regular care. The program will involve patients from Penn Presbyterian Medical Center with a set of diagnoses and will provide patients with enhanced services upon discharge from the emergency department.

Full description

The PATH program seeks to provide patients with enhanced services upon discharge from the emergency department, including visiting home nurses, visiting home physical and occupational therapists, scheduled frequent telephone visits with a medical provider, care coordination to arrange outpatient evaluation and testing, social work services, and other services. The purpose of this study is to evaluate whether the PATH program allows patients to spend more days at home in comparison to patients who receive regular care.

The broad goal of this program is to provide patients with a personalized package of enhanced services following discharge from the emergency department. In some cases, patients enrolled in the PATH program are likely to be discharged home regardless of enrollment, but are deemed potentially high-risk for returning to the hospital due to their illness or other factors. In other cases, enrolled patients might otherwise have been hospitalized but decide with their clinician that recovery at home is possible with the increased supervision and care provided by PATH. For all patients, we seek to determine whether PATH is effective in expediting patient recovery from acute illness and reduce the time spent in hospital or nursing facilities.

Enrollment: 72 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Stable (Patients are deemed stable by ED clinician and PATH clinician per review of vital signs, history, exam, test results, and functional status)
• Have active insurance
• Domiciled at home (Patients must live in the community and not in nursing facility, shelter, or otherwise homeless)
• Safe home environment
• Live in Penn Medicine Home Health (PMHH) geographic catchment if enrolled in PMHH services

Exclusion criteria

• Substance use disorder (No active untreated SUD, including alcohol, opioids, cocaine, or stimulants)
• Serious mental health condition
• Police custody
• Homelessness
• Anticipated procedures or surgeries
• IV access (Patients with need for home infusion services or frequent blood testing after discharge must have standard level of IV access)

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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72 participants in 2 patient groups

PATH Intervention

Experimental group

Description:

Patients in the treatment arm will receive a personalized plan of care upon discharge from the emergency department.

Treatment:

Other: PATH Intervention

Routine Care

No Intervention group

Description:

Patients in the control arm will receive standard-of-care services (the care plan that the emergency physician would normally offer if PATH were not available) without PATH enrollment.