A Prospective Randomised Control Trial to Study the Effectiveness of a Health Service Innovation Using a Modified Virtual Ward Model to Prevent Unscheduled Readmission of High Risk Patients
NCT ID: NCT02325752
Last Updated: 2017-02-10
Study Results
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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COMPLETED
NA
840 participants
INTERVENTIONAL
2011-08-31
2013-01-31
Brief Summary
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
PARALLEL
HEALTH_SERVICES_RESEARCH
SINGLE
Study Groups
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Control
Patients in the control group received usual care by the hospital. There was no contact between the patients in the control group and the study team throughout the 3 months interval. A scheduled telephone call was made at the end of 3 months when they were invited to participate in a telephone survey.
No interventions assigned to this group
Intervention
Intervention
Intervention
A multidisciplinary team delivered the transitional care program.
Our transitional care program focused on four key areas:
1. Post discharge surveillance of the patient to ensure adherence to care plans.
2. Coordination of follow-up visits with specialist care providers.
3. Patent education and care giver training.
4. Activation of community and social services.
Upon recruitment, the patients were interviewed and assessed by the team nurse prior to their discharge. Intervention starts upon discharge from the hospital. The duration of the intervention program was 3 months. A follow-up by telephone was made within 72 hours after discharge to assess patient's condition and adherence to treatment plan. Home visits were made within 2 weeks after discharge.
Interventions
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Intervention
A multidisciplinary team delivered the transitional care program.
Our transitional care program focused on four key areas:
1. Post discharge surveillance of the patient to ensure adherence to care plans.
2. Coordination of follow-up visits with specialist care providers.
3. Patent education and care giver training.
4. Activation of community and social services.
Upon recruitment, the patients were interviewed and assessed by the team nurse prior to their discharge. Intervention starts upon discharge from the hospital. The duration of the intervention program was 3 months. A follow-up by telephone was made within 72 hours after discharge to assess patient's condition and adherence to treatment plan. Home visits were made within 2 weeks after discharge.
Eligibility Criteria
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Inclusion Criteria
* LACE score of ≥10.
Exclusion Criteria
* No telephone contact or a resident address
* Residing in long term care facilities.
21 Years
ALL
Yes
Sponsors
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Agency for Integrated Care, Singapore
OTHER
Duke-NUS Graduate Medical School
OTHER
Singapore General Hospital
OTHER
Responsible Party
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Principal Investigators
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Kheng Hock Lee, MBBS
Role: PRINCIPAL_INVESTIGATOR
Singhealth Foundation
References
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Lee KH, Low LL, Allen J, Barbier S, Ng LB, Ng MJ, Tay WY, Tan SY. Transitional care for the highest risk patients: findings of a randomised control study. Int J Integr Care. 2015 Oct 22;15:e039. doi: 10.5334/ijic.2003. eCollection 2015 Oct-Dec.
Other Identifiers
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2011/380/E
Identifier Type: -
Identifier Source: org_study_id
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