hospital-wide care that can (not) be planned hospital admission
Conditions
Interventions
Intervention (if applicable): Patients will be discharged to the virtual ward 
with monitoring, diagnostics, and treatment at home.
Sponsors
Erasmus MC, Universitair Medisch Centrum Rotterdam
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: 1. Written informed consent is obtained from the patient 2. The patient is >= 18 years old 3. The patient has a family member or caregiver (over 18 years old) who lives at the same address as the patient. 4. The patient has access to transportation 24 hours a day, with a maximum travel time of 45 minutes to reach the hospital. 5. The patient (or their family member/caregiver) has a mobile phone with data and call-ing capabilities 6. The patient (or their family member/caregiver) possesses sufficient digital skills.
Exclusion criteria
Exclusion criteria: 1. The patient is unable to communicate in Dutch 2. The patient has been diagnosed with dementia, psychosis, or another disorder that se-verely impairs their judgment capability. 3. The patient has a Clinical Frailty score (CSF)>6 4. The patient is receiving end of life care. 5. The patient is addicted to drugs or alcohol, excluding smoking. 6. The patient's pain is inadequately treated, requiring intravenous pain medication. 7. The patient has received interventions within the past 24 hours to improve vital pa-rameters and the MEWS score at the time of transfer to the Virtual Ward is >2. 8. The patient is undergoing oxygen therapy at a flow rate > 5 liters per minute 9. Patient complexity or treatment intensity is not feasible in the Virtual Ward; home care, diagnostics, or treatment are not suitable for the Virtual Ward setting due to current or-ganizational constraints. 10. The physician determines that treatment in the Virtual Ward is not safe for the patient for any reason; for example, when the treating physician concludes that the patient is not sufficiently self-reliant in terms of self-care for treatment in the setting of Virtual Ward. 11. The treating physician or the investigator expects that the patient will spend less than 24 hours in the Virtual Ward.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To assess the feasibility of the Virtual Ward across six pre-defined sub-cohorts of non-elective hospitalized patients by determining the percentage of patients who provide informed consent and are successfully transferred to the Virtual Ward, with a feasibility threshold set at 30% for this pilot phase (adherence). Feasibility is determined per sub-cohort | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. To document the time frame from study inclusion to transfer to the Virtual Ward. 2. To document clinical outcomes which can guide future implementation: • What type of patient is included (i.e. baseline characteristics as shown in 8.1.3.). • The generation of notifications during monitoring, including the type and quantity, as well as the actions taken after a notification is generated • Number and time of contact moments between patient and virtual ward employee/treating physician. • Length of stay in the hospital ward. • Length of stay in the Virtual Ward. • Adverse (safety) events during admission in the Virtual Ward. • Readmission rate to the hospital. 4. To explore experiences, barriers and facilitators about patients and healthcare providers to use the Virtual Ward through structured interviews to guide future implementation strategies. | — |
Countries
Netherlands
Contacts
Public ContactC.A.M. van de Weg
Erasmus MC, Universitair Medisch Centrum Rotterdam
Outcome results
None listed