Effect of a Quality Improvement Initiative to Address Social Determinants of Health on Rehospitalization Rates in Patients With Heart Failure

A Novel Strategy for Addressing Social Barriers to a Successful, Sustained Discharge From the Hospital for Acute Heart Failure

Status

Recruiting

Phases

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT05388097

Enrollment

320

Registered

2022-05-24

Start date

2021-05-03

Completion date

2026-06-30

Last updated

2024-06-14

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Heart Failure

Keywords

heart failure

Brief summary

The objective of this program is to improve post-acute care coordination for necessary social services for patients leaving the hospital after recovering from an episode of decompensated heart failure.

Interventions

OTHERManaged Services

coordination of care and assistance with community resources (food, transportation)

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

SUPPORTIVE_CARE

Masking

NONE

Eligibility

Sex/Gender

ALL

Age

18 Years to 99 Years

Healthy volunteers

Inclusion criteria

* Aged 18-99 years * Resident of Missouri or Kansas * Current inpatient admission for acute heart failure

Exclusion criteria

* Under 18 years or over 99 years of age

Design outcomes

Primary

Measure	Time frame	Description
Reduction in all-cause re-hospitalization	2 years	reduction in all-cause re-hospitalization via improved post-acute care coordination

Countries

United States

Contacts

Primary ContactStacy Farr, PhD

sfarr@saint-lukes.org816-932-5846

Backup ContactTracy Breeding

tbreeding@saint-lukes.org816-932-2590

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026