Validation and Implementation Design of an Epic Systems 30-day Unplanned Readmission Risk Model

Wake Forest University (WFU)

Status: Completed

Conditions: Unplanned Hospital Readmissions; Patients at High Risk of Unplanned Readmission

Treatments: Behavioral: Epic 30-day unplanned readmission risk score

Study type: Interventional

Funder types: Other

Identifiers

NCT05413889

IRB00079395

Details and patient eligibility

About

The objective is to assess the implementation of a computerized clinical decision support (cCDS) tool for identifying patients at high risk of unplanned readmission who could benefit from existing care programs aimed at reducing readmissions

Full description

Providers from either service, which includes attending physicians, residents, hospitalists, and advanced practice providers (APPs), will be randomly allocated to an intervention group (IG) or control group (CG). The IG will consist of placing the Epic 30-day unplanned readmission risk score in the story board of providers. If a patient is identified as having a high risk of readmission defined as readmission risk >20%, a link to transitional and supportive care services (TSC) will be appear in the story board. Providers will determine which TSC is best for the patient and may order whichever TSC is appropriate for the patient. The study team will not recommend TSCs. The risk of readmission score will be present from the time of admission for those in the IG. The CG will have the same TSC orders available to them; however, they will not have the risk of readmission score present in their workflow, as such the embedded link to TSC will also not be present.

Enrollment: 68 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients of Atrium Health Wake Forest Baptist Hospital (AHWFBH)
• 18 years or older
• meeting inpatient criteria
• admitted to hospitalist or general medicine teaching services
• Providers on the hospitalist or general medicine teaching services

Exclusion criteria

• Psychiatric diagnoses during index or subsequent admission
• left Against Medical Advice (AMA)
• planned readmission
• died during index admission
• Providers who opt out of the study

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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68 participants in 2 patient groups

intervention group (IG)

Experimental group

Description:

The IG will consist of placing the Epic 30-day unplanned readmission risk score in the story board of providers - If a patient is identified as having a high risk of readmission defined as readmission risk \>20%, a link to transitional and supportive care services (TSC) will be appear in the story board

Treatment:

Behavioral: Epic 30-day unplanned readmission risk score

control group (CG)

No Intervention group

Description:

The CG will have the same transitional and supportive care services (TSC) orders available to them; however, they will not have the risk of readmission score present in their workflow