Asthma, Chronic Obstructive Pulmonary Disease (COPD), Bronchitis, Conditions, Diabetes, Fever, Heart Failure, Hypertension, Infections, Renal and Urinary Disorders
Conditions
Keywords
home hospital, hospital at home, hospital in the home
Brief summary
The purpose of this study is to examine the implementation, intervention effectiveness, and dissemination of a digital acute care delivery model for improving selected health outcomes in the Hospital at Home population.
Detailed description
The investigators will conduct a mixed-methods quasi-experimental research study that will explore the effectiveness of the Hospital at home programs using qualitative interviews and quantitative data as a means to also conduct a process evaluation related to the implementation and efficacy of Hospital at Home programs. The purpose of this pragmatic study is to inform scalability beyond the initial site for implementation within a large healthcare system with a diverse patient population located in various communities, including rural and urban locations.
Interventions
OTHERDigital Care Solution as supportive personalized care
Patients will need to meet screening and inclusion criteria at time of enrollment. As a pragmatic study, researchers will not determine criteria or management of care aspects for patients.
OTHERTraditional Hospital Level Care
Patients will be cared for in the inpatient setting for management of diseases that meet screening and inclusion criteria at time of enrollment for hospital at home. As a pragmatic study, researchers will not determine criteria or management of care aspects for patients.
Sponsors
OSF Healthcare System
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients 18 years and older who are admitted into the Hospital at Home program after presenting to the emergency department or who are inpatients that can be cared at home for hospital level needs * Patients meeting the hospital's criteria for admission by diagnosis type (e.g., heart failure, respiratory infections and inflammations, renal failure, diabetes, pneumonia, bronchitis, chronic obstructive pulmonary disease, fever and inflammatory conditions, viral illnesses, other disorders of the nervous system). Diagnoses are determined by clinicians not researchers. * Patients will need to reside within 30 minutes' drive time from the hospital Patient caregiver inclusion criteria: (not required for patient participation): * Age \>= 18 years old * as capacity to consent to study Clinician or stakeholder inclusion criteria: * Any member of the home hospital clinical team (a healthcare professional who providing care or equipment for use in the home) who will be participating in delivery of healthcare services, * Any member of the hospital care teams, including the screening and recruitment of patients for the home hospital intervention and/or providing care to patients that enroll in the intervention that is provided * Any member of the leadership team who are involved in the operational aspects of program delivery
Exclusion criteria
* Need for long-term facility level care or current residence in a facility of this type * No one will be excluded on the basis of sex or race
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Composite of all-cause mortality for patients admitted to digital hospital | Up to 30 days, (date of death from any cause, whichever came first, assessed up to 30 days) | Total number of deaths over total number of patients admitted to the digital hospital. |
| 30-day readmission rate | Up to 30 days (date of readmission from any cause, whichever came first, assessed up to 30 days) | Number of 30-day readmissions as defined by Organization using preset criteria |
| Patient Satisfaction at discharge | up to 1 week | 1-item measure: I would recommend this \[insert program name\] to others, assessed at discharge name\] to others. |
| Patient Perception of Digital Care at discharge | up to 1 week | Results of Digital Care - Likert Scale (very satisfied to very dissatisfied) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Escalations (for management and treatment of early decompensation) | up to 2 weeks | percentage of patients escalated over total hospital digital encounters |
| Unplanned readmission within 30-days of discharge | up to 30 days | Number of 30-day readmissions over total number of discharges |
| Length of Stay | assessed up to 2 weeks | Day of admission to day of discharge, assessed up to 2 months |
| Number of participants with Hospital Acquired Infections | assessed up to 1 week | Number of hospital acquired infections reported (CAUTI, CLABSI, etc.) |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORColleen Klein, PhD, APRN
OSF HealthCare
Outcome results
None listed