Acute Kidney Injury, Asthma, Community Acquired Pneumonia, Heart Failure, Venous Thromboembolism
Conditions
Keywords
Clinical Pathways, Length of Stay, Patient-Centered Care, Pragmatic Randomized Controlled Trial
Brief summary
The aim of this study is to determine if by providing a collaborative, integrated pathway-based healthcare compared to the usual healthcare, whether or not this would be superior in reducing the length of hospital stay across five high frequency /high risk medical diagnoses: Acute Venous Thromboembolism, Acute Kidney Injury, Community Acquired Pneumonia, Adult Left Ventricular Heart Failure, and Asthma.
Detailed description
This study is a pragmatic randomized controlled trial. To date, there is a scarcity of randomized controlled trials looking at pathway-based, patient-centered healthcare versus usual care in several high-risk or high volume diagnoses that account for the vast majority of hospitalizations in medical settings. In this study, the pathway care intervention is a collaborative effort that involves healthcare professionals from multiple departments, including pharmacists, health educators, nurses, social workers, nutritionists, and quality management. For patients allocated to the usual care, these healthcare professionals will deliver standardized care when consulted. For pathway care patients, this collaborative healthcare will be default.
Interventions
OTHERPathway-Based Care
Patients who are randomly allocated to Pathway Care will be treated by the Pathway Clinical Teaching Unit as well as other collaborative healthcare professionals (pharmacists, nurses, health educators, nutritionists, and social workers). The Pathway Care physicians will have access to the Clinical Care Plan on the QuadraMed, which is a detailed, organized, day-to-day treatment plan that includes pre-set orders and medications. Physicians for the patients on Usual Care will not have access to this information, and the collaborative healthcare will only be provided upon consultation.
Sponsors
Majed Aljeraisy
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
14 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Inclusion Criteria (Overall Criteria): * One principle diagnosis * Hemodynamic Stability 2. Inclusion Criteria (Specific to each Diagnosis): Acute Venous Thromboembolism: * New onset / in-patient Acute Kidney Injury: * Patients with increased serum creatinine of more than 50% from baseline Community Acquired Pneumonia: * Age limit Adult Left Ventricular Heart Failure: * Age limit Asthma * Acute exacerbation of Asthma 3.
Exclusion criteria
(Overall Criteria): * Intensive Care Unit (ICU) patients * Pregnancy 4.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Decrease in length of hospital stay by two days | During hospitalization period of 7 to 10 days |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 30-Day Rehospitalization | After discharge up to 30 days | To determine the effect of the pathway-based care versus usual care on 30-day rehospitalization rates for the same diagnosis |
| Determinants of the Length of Stay | Upon admission until discharge | — |
| Pathway Care Specific Clinical Outcomes | Upon admission until discharge | For pathway care, there are specific targeted outcomes that ought to be met. |
Countries
Saudi Arabia
Outcome results
None listed