The CARS Study: Communicating About Readiness (for Discharge)

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

COMPLETED

Clinical Phase

NA

Total Enrollment

604 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-03-31

Study Completion Date

2016-05-31

Brief Summary

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The purpose of this study is to improve the experience of discharge of adult medical surgical patients through improved discharge preparation communication between patients and care team members, with subsequent improvement in the post-discharge experience. Obtaining multiple perspectives on discharge readiness creates the opportunity for patient and care team to partner in identifying deficiencies in discharge readiness that warrant anticipatory, compensatory, or corrective interventions prior to discharge, with the goal of averting post-discharge problems and utilization. The results will also inform development and translation of tools for assessment of discharge readiness to clinical care environments.

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Detailed Description

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Specific Aims are to:

1. Describe patterns of communication about discharge and collaboration among members of the health care team
2. Conduct psychometric testing of 3 forms of the Readiness for Hospital Discharge Scale (RHDS - MD, RN, Patient)
3. Describe relationships between care team communication, patient perceptions of quality of discharge preparation and perceived readiness for discharge, care team (RN and MD) assessments of discharge readiness, and post-discharge outcome ( post-discharge coping difficulty, Emergency Department (ED) use, and 30 day readmission.
4. Determine the impact of an intervention with the inpatient care team to improve discharge preparation communication.

H1: Patient perceptions of discharge readiness, post-discharge coping difficulty, ED use and readmission will improve following a care team educational intervention about discharge preparation, compared to pre-intervention baseline measures.

H2: Care team members will report improved frequency and amount of discharge preparation communication following a care team educational intervention about discharge preparation, compared to pre-intervention baseline measures.

H3: RN-MD collaboration will increase following a care team educational intervention about discharge preparation, compared to pre-intervention baseline measures

Conditions

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Hospital Discharge Communication Processes

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SEQUENTIAL

Before/after implementation of a health team communication intervention. 2 samples.

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Health team educational intervention

Agency for Healthcare Research and Quality (AHRQ) TeamSTEPPS approach will be used to redesign health team communication processes regarding preparation for discharge. This redesign will be followed by education for all health team members.

Group Type EXPERIMENTAL

Health Team Educational Intervention

Intervention Type OTHER

AHRQ TeamStepps processes will be used to redesign health team discharge communication processes and an educational intervention for health care team members

Control pre-intervention

Usual care control before implementation of the health team communication intervention

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Health Team Educational Intervention

AHRQ TeamStepps processes will be used to redesign health team discharge communication processes and an educational intervention for health care team members

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* inpatient care team members from 2 nursing units of an academic medical center: Attending physician, resident, medical students, mid-level providers, staff RNs, and case managers/discharge coordinators
* adult medical-surgical patients admitted the 2 nursing units who are at least 18 years of age, speak English, and discharged directly home