Acute Disease
Conditions
Keywords
Patient Care Planning, Decision Making, Advance Care Planning
Brief summary
The objective of this clinical trial is to investigate the impact of implementing a tool for adjusting the level of diagnostic and therapeutic intensity in the clinical practice of physicians attending hospitalized patients. The goal of this clinical trial is to investigate the impact of a tool for adjusting diagnostic and therapeutic intensity in hospitalized patients. The main question it aims to answer is: Is there a difference in patient mortality when using the aforementioned tool? The participating physicians will be grouped into 4 groups (5 physicians each). Each group will progressively (every 3 months) incorporate the use of the aforementioned tool into their usual clinical practice.
Interventions
OTHERLevels of Diagnostic and Therapeutic Intervention tool by Fontecha and col.
During the intervention periods, participating physicians will integrate into their usual clinical practice a tool for adjusting diagnostic and therapeutic intensity designed by Fontecha-Gómez and colleagues. The tool for adjusting the level of diagnostic and therapeutic intensity classifies patients' profiles into 5 groups based on the recommended level of adjustment.
The participating physicians will carry out the standard clinical practice currently performed in the study centers. This means that during this period, the diagnostic and therapeutic adjustment tool or any similar tool will not be introduced into routine clinical practice.
Sponsors
Consorci Sanitari de l'Alt Penedès i Garraf
Study design
Allocation
RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Outcomes Assessor)
Intervention model description
The participating physicians will be grouped into 4 clusters (5 physicians each). Each cluster will progressively (every 3 months) incorporate the use of a level of diagnostic and therapeutic intensity tool into their usual clinical practice.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Physician belonging to the non-surgical medical area. * Routine clinical activity on a hospital ward caring for hospitalized patients.
Exclusion criteria
* Physician belonging to the Oncology-Hematology/Palliative Care Hospitalization Unit. * Refusal to participate in the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| In-hospital Patient Mortality at 90 days from hospital discharge | 90 days from hospital discharge | Percentage of patients who die during hospitalization until 90 days from hospital discharge. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| In-hospital Patient Mortality at 6 months from hospital discharge | 6 months from hospital discharge | Percentage of patients who die during hospitalization until 6 months from hospital discharge. |
| In-hospital Patient Mortality at 1 year from hospital discharge | 1 year from hospital discharge | Percentage of patients who die during hospitalization until 1 year from hospital discharge. |
| Delirium Incidence | hospital discharge, assessed up to day 90 | Percentage of patients with delirium occurrence during hospital admission (delirium already present at the time of admission will not be considered). Delirium will be evaluated through Confusion Assessment Method (CAM) |
| Pressure Ulcer Incidence | hospital discharge, assessed up to day 90 | Percentage of patients with pressure ulcer occurrence during hospital admission (pressure ulcers already present at the time of admission will not be considered). |
| Hospital stay | hospital discharge, assessed up to day 90 | Hospital stay in days |
| Hospital readmission for any reason | 30 days from hospital discharge | Percentage of patients readmitted for any reason within 30 days of hospital discharge. |
| Hospital readmission for same reason | 30 days from hospital discharge | Percentage of patients readmitted for the same reason within 30 days of hospital discharge. |
| Patients admitted to the Intensive Care Unit (ICU) | hospital discharge, assessed up to day 90 | Percentage of patients admitted to the ICU during hospitalization |
| Calls to the on-call doctor | hospital discharge, assessed up to day 90 | Number of calls to the on-call doctor during hospital admission |
| Healthcare expenditure | through study completion, an average of 1.5 years | Descriptive analysis of healthcare expenditure associated with each intervention, using the billing data from the center. |
| Mortality at ICU | hospital discharge, assessed up to day 90 | Percentage of patients admitted to the ICU |
Countries
Spain
Contacts
Primary ContactHelena Camell
Backup ContactNoemi Casaponsa
Outcome results
None listed