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A Virtual Ward to Reduce Readmissions After Hospital Discharge

NCT ID: NCT01108172

Last Updated: 2013-12-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

1928 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-06-30

Study Completion Date

2014-06-30

Brief Summary

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The purpose of this study is to see whether a Virtual Ward reduces readmissions after hospital discharge.

Detailed Description

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We will conduct a pragmatic, randomized controlled trial to evaluate a new model of care for high-risk medical patients after discharge from hospital. This new model of care has two key elements. First, we will use the LACE index (see citation below for details) to identify patients who are at high risk of readmission or death after hospital discharge. These patients will be randomized to either the Virtual Ward or usual care on the day of discharge. Although patients being cared for in the Virtual Ward will reside at home, they will benefit from a hospital-like interdisciplinary team, a shared set of notes, a single point of contact, round-the-clock physician availability and increased co-ordination of specialist, primary and home-based community care for several weeks after hospital discharge.

Conditions

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Acute Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Usual Care

Group Type ACTIVE_COMPARATOR

Usual care

Intervention Type OTHER

The usual care provided to patients after discharge from hospital

Virtual Ward

Group Type EXPERIMENTAL

Virtual Ward

Intervention Type OTHER

A multidisciplinary team to optimize medical and social care for patients residing in their own homes

Interventions

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Virtual Ward

A multidisciplinary team to optimize medical and social care for patients residing in their own homes

Intervention Type OTHER

Usual care

The usual care provided to patients after discharge from hospital

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Discharge from medical service
* LACE score greater than or equal to 10
* Age greater than or equal or 18
* Resident in Toronto Central Local Health Integration Network catchment area
* Patient or designate able to speak English well enough for follow up telephone calls

Exclusion Criteria

* Previously enrolled in study
* Discharged to a rehabilitation or complex continuing care facility
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Canadian Institutes of Health Research (CIHR)

OTHER_GOV

Sponsor Role collaborator

Toronto Central Local Health Integration Network

UNKNOWN

Sponsor Role collaborator

Ontario Ministry of Health and Long Term Care

OTHER_GOV

Sponsor Role collaborator

Toronto Central Community Care Access Centre

OTHER

Sponsor Role collaborator

Women's College Hospital

OTHER

Sponsor Role collaborator

University Health Network, Toronto

OTHER

Sponsor Role collaborator

Sunnybrook Health Sciences Centre

OTHER

Sponsor Role collaborator

Unity Health Toronto

OTHER

Sponsor Role lead

Responsible Party

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Irfan Dhalla

Staff Physician & Scientist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Irfan Dhalla, MD, MSc

Role: PRINCIPAL_INVESTIGATOR

St. Michael's Hospital/University of Toronto

Locations

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St. Michael's Hospital

Toronto, Ontario, Canada

Site Status

Sunnybrook Health Sciences Centre

Toronto, Ontario, Canada

Site Status

Toronto Central Community Care Access Centre

Toronto, Ontario, Canada

Site Status

University Health Network

Toronto, Ontario, Canada

Site Status

Women's College Hospital

Toronto, Ontario, Canada

Site Status

Countries

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Canada

References

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van Walraven C, Dhalla IA, Bell C, Etchells E, Stiell IG, Zarnke K, Austin PC, Forster AJ. Derivation and validation of an index to predict early death or unplanned readmission after discharge from hospital to the community. CMAJ. 2010 Apr 6;182(6):551-7. doi: 10.1503/cmaj.091117. Epub 2010 Mar 1.

Reference Type BACKGROUND
PMID: 20194559 (View on PubMed)

Dhalla IA, O'Brien T, Morra D, Thorpe KE, Wong BM, Mehta R, Frost DW, Abrams H, Ko F, Van Rooyen P, Bell CM, Gruneir A, Lewis GH, Daub S, Anderson GM, Hawker GA, Rochon PA, Laupacis A. Effect of a postdischarge virtual ward on readmission or death for high-risk patients: a randomized clinical trial. JAMA. 2014 Oct 1;312(13):1305-12. doi: 10.1001/jama.2014.11492.

Reference Type DERIVED
PMID: 25268437 (View on PubMed)

Other Identifiers

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216852-PHE-CEAJ-25173

Identifier Type: -

Identifier Source: org_study_id