Trial Outcomes & Findings for Discharge Follow-up Phone Call Program (NCT NCT03050918)
NCT ID: NCT03050918
Last Updated: 2019-07-29
Results Overview
Number of participants with in-patient re-admissions
Recruitment status
COMPLETED
Study phase
NA
Target enrollment
3054 participants
Primary outcome timeframe
30 days
Results posted on
2019-07-29
Participant Flow
Participant milestones
| Measure |
Phone Call Group (Intervention Arm)
Follow-up phone call program: Patients will receive the first call attempt within 72 hours of hospital discharge with a maximum of 3 call attempts by the study nurse made up until post-discharge day 7. The semi-structured script embedded within the program specific electronic health record Discharge Phone Call Starform is used to guide a conversation to obtain information on potential causes of hospital readmission that can be identified and addressed to improve each patient's transition to outpatient care.
|
Usual Care Group (Control Arm)
Patients assigned to the Control Group receive standard discharge planning and follow-up per the usual care of their medical providers.
|
|---|---|---|
|
Overall Study
STARTED
|
1534
|
1520
|
|
Overall Study
COMPLETED
|
1534
|
1520
|
|
Overall Study
NOT COMPLETED
|
0
|
0
|
Reasons for withdrawal
Withdrawal data not reported
Baseline Characteristics
Discharge Follow-up Phone Call Program
Baseline characteristics by cohort
| Measure |
Phone Call Group (Intervention Arm)
n=1534 Participants
Follow-up Phone Call Program: Patients will receive the first call attempt within 72 hours of hospital discharge with a maximum of 3 call attempts by the study nurse made up until post-discharge day 7. The semi-structured script embedded within the program specific electronic health record Discharge Phone Call Starform is used to guide a conversation to obtain information on potential causes of hospital readmission that can be identified and addressed to improve each patient's transition to outpatient care.
|
Usual Care Group (Control Arm)
n=1520 Participants
Patients assigned to the Control Group receive standard discharge planning and follow-up per the usual care of their medical providers.
|
Total
n=3054 Participants
Total of all reporting groups
|
|---|---|---|---|
|
Age, Continuous
|
52.4 years
STANDARD_DEVIATION 17.7 • n=5 Participants
|
53.4 years
STANDARD_DEVIATION 18.1 • n=7 Participants
|
52.9 years
STANDARD_DEVIATION 17.9 • n=5 Participants
|
|
Sex: Female, Male
Female
|
761 Participants
n=5 Participants
|
749 Participants
n=7 Participants
|
1510 Participants
n=5 Participants
|
|
Sex: Female, Male
Male
|
773 Participants
n=5 Participants
|
771 Participants
n=7 Participants
|
1544 Participants
n=5 Participants
|
|
Race (NIH/OMB)
American Indian or Alaska Native
|
0 Participants
n=5 Participants
|
0 Participants
n=7 Participants
|
0 Participants
n=5 Participants
|
|
Race (NIH/OMB)
Asian
|
0 Participants
n=5 Participants
|
0 Participants
n=7 Participants
|
0 Participants
n=5 Participants
|
|
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
|
0 Participants
n=5 Participants
|
0 Participants
n=7 Participants
|
0 Participants
n=5 Participants
|
|
Race (NIH/OMB)
Black or African American
|
323 Participants
n=5 Participants
|
314 Participants
n=7 Participants
|
637 Participants
n=5 Participants
|
|
Race (NIH/OMB)
White
|
1164 Participants
n=5 Participants
|
1158 Participants
n=7 Participants
|
2322 Participants
n=5 Participants
|
|
Race (NIH/OMB)
More than one race
|
0 Participants
n=5 Participants
|
0 Participants
n=7 Participants
|
0 Participants
n=5 Participants
|
|
Race (NIH/OMB)
Unknown or Not Reported
|
47 Participants
n=5 Participants
|
48 Participants
n=7 Participants
|
95 Participants
n=5 Participants
|
|
Region of Enrollment
United States
|
1534 participants
n=5 Participants
|
1520 participants
n=7 Participants
|
3054 participants
n=5 Participants
|
|
Highest Education/grade completed
|
13.2 grade level in years
STANDARD_DEVIATION 3.5 • n=5 Participants
|
12.9 grade level in years
STANDARD_DEVIATION 3.5 • n=7 Participants
|
13.07 grade level in years
STANDARD_DEVIATION 3.54 • n=5 Participants
|
|
Brief Health Literacy Score
|
11.8 scores on a scale
STANDARD_DEVIATION 3.5 • n=5 Participants
|
12.0 scores on a scale
STANDARD_DEVIATION 3.5 • n=7 Participants
|
11.91 scores on a scale
STANDARD_DEVIATION 3.47 • n=5 Participants
|
|
Established Primary Care Provider
|
982 Participants
n=5 Participants
|
1018 Participants
n=7 Participants
|
2000 Participants
n=5 Participants
|
|
Hospital Length of Stay
|
4.5 days
STANDARD_DEVIATION 4.3 • n=5 Participants
|
4.6 days
STANDARD_DEVIATION 4.7 • n=7 Participants
|
4.54 days
STANDARD_DEVIATION 4.48 • n=5 Participants
|
|
Any time on Intensive Care Unit during stay
|
281 Participants
n=5 Participants
|
308 Participants
n=7 Participants
|
589 Participants
n=5 Participants
|
|
Predicted Re-admission risk before discharge
|
24.4 percent risk
STANDARD_DEVIATION 15.9 • n=5 Participants
|
23.4 percent risk
STANDARD_DEVIATION 14.2 • n=7 Participants
|
23.9 percent risk
STANDARD_DEVIATION 15.1 • n=5 Participants
|
|
In-patient Admission in prior 6 months
|
483 Participants
n=5 Participants
|
461 Participants
n=7 Participants
|
944 Participants
n=5 Participants
|
|
Mean number of In-Patient admissions in the prior 6 months
|
0.6 in-patient admissions
STANDARD_DEVIATION 1.2 • n=5 Participants
|
0.6 in-patient admissions
STANDARD_DEVIATION 1.1 • n=7 Participants
|
0.6 in-patient admissions
STANDARD_DEVIATION 1.184 • n=5 Participants
|
|
CMS Re-admission Penalty Group: COPD Exacerbation
|
320 Participants
n=5 Participants
|
327 Participants
n=7 Participants
|
647 Participants
n=5 Participants
|
|
CMS Re-admission Penalty Group: Pneumonia
|
384 Participants
n=5 Participants
|
371 Participants
n=7 Participants
|
755 Participants
n=5 Participants
|
|
CMS Re-admission Penalty Group: Heart Failure
|
234 Participants
n=5 Participants
|
234 Participants
n=7 Participants
|
468 Participants
n=5 Participants
|
|
CMS Re-admission Penalty Group: Acute Myocardial Infarction
|
79 Participants
n=5 Participants
|
80 Participants
n=7 Participants
|
159 Participants
n=5 Participants
|
|
CMS Re-admission Penalty Group: Stroke
|
22 Participants
n=5 Participants
|
37 Participants
n=7 Participants
|
59 Participants
n=5 Participants
|
|
CMS Re-admission Penalty Group: Total hip/knee
|
1 Participants
n=5 Participants
|
1 Participants
n=7 Participants
|
2 Participants
n=5 Participants
|
|
CMS Re-admission Penalty Group: Coronary Artery Bypass Graph
|
0 Participants
n=5 Participants
|
0 Participants
n=7 Participants
|
0 Participants
n=5 Participants
|
|
CMS Re-admission Penalty Group: None
|
836 Participants
n=5 Participants
|
825 Participants
n=7 Participants
|
1661 Participants
n=5 Participants
|
PRIMARY outcome
Timeframe: 30 daysNumber of participants with in-patient re-admissions
Outcome measures
| Measure |
Phone Call Group (Intervention Arm)
n=1534 Participants
Follow-up phone call program: Patients will receive the first call attempt within 72 hours of hospital discharge with a maximum of 3 call attempts by the study nurse made up until post-discharge day 7. The semi-structured script embedded within the program specific electronic health record Discharge Phone Call Starform is used to guide a conversation to obtain information on potential causes of hospital readmission that can be identified and addressed to improve each patient's transition to outpatient care.
|
Usual Care Group (Control Arm)
n=1520 Participants
Patients assigned to the Control Group receive standard discharge planning and follow-up per the usual care of their medical providers.
|
|---|---|---|
|
Number of Participants With In-patient Re-admissions
|
228 Participants
|
232 Participants
|
SECONDARY outcome
Timeframe: Within 60 days of DischargePopulation: Patient experience data were retrieved from the hospital quality and patient safety office at 60 days, but assessment was administered via a survey sent to patients at their home after hospital discharge. Scores are based on the number of surveys returned
Measured as mean Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction scores. Higher scores indicate more patient satisfaction. Range is 0-9 with 9 being the most satisfied.
Outcome measures
| Measure |
Phone Call Group (Intervention Arm)
n=227 Participants
Follow-up phone call program: Patients will receive the first call attempt within 72 hours of hospital discharge with a maximum of 3 call attempts by the study nurse made up until post-discharge day 7. The semi-structured script embedded within the program specific electronic health record Discharge Phone Call Starform is used to guide a conversation to obtain information on potential causes of hospital readmission that can be identified and addressed to improve each patient's transition to outpatient care.
|
Usual Care Group (Control Arm)
n=249 Participants
Patients assigned to the Control Group receive standard discharge planning and follow-up per the usual care of their medical providers.
|
|---|---|---|
|
Patient Satisfaction: Experience
|
8.2 score on a scale
Standard Deviation 1.8
|
8.3 score on a scale
Standard Deviation 1.4
|
SECONDARY outcome
Timeframe: Within 60 days of DischargePopulation: Patient experience data were retrieved from the hospital quality and patient safety office at 60 days, but assessment was administered via a survey sent to patients at their home after hospital discharge. Scores are based on the number of surveys returned.
Measured as mean Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction scores. Number of patients that reported a score of 3. Range is 0-3 with 3 being highest satisfaction.
Outcome measures
| Measure |
Phone Call Group (Intervention Arm)
n=227 Participants
Follow-up phone call program: Patients will receive the first call attempt within 72 hours of hospital discharge with a maximum of 3 call attempts by the study nurse made up until post-discharge day 7. The semi-structured script embedded within the program specific electronic health record Discharge Phone Call Starform is used to guide a conversation to obtain information on potential causes of hospital readmission that can be identified and addressed to improve each patient's transition to outpatient care.
|
Usual Care Group (Control Arm)
n=247 Participants
Patients assigned to the Control Group receive standard discharge planning and follow-up per the usual care of their medical providers.
|
|---|---|---|
|
Patient Satisfaction: Likelihood to Recommend the Facility (Top Box Rating)
|
168 Participants
|
193 Participants
|
SECONDARY outcome
Timeframe: Within 60 days of DischargePopulation: Patient experience data were retrieved from the hospital quality and patient safety office at 60 days, but assessment was administered via a survey sent to patients at their home after hospital discharge. Scores are based on the number of surveys returned
Measured as mean Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction scores. Number of patients that rated the Hospital Experience as 9. Scale range is 0-9. Higher scores indicate more patient satisfaction.
Outcome measures
| Measure |
Phone Call Group (Intervention Arm)
n=227 Participants
Follow-up phone call program: Patients will receive the first call attempt within 72 hours of hospital discharge with a maximum of 3 call attempts by the study nurse made up until post-discharge day 7. The semi-structured script embedded within the program specific electronic health record Discharge Phone Call Starform is used to guide a conversation to obtain information on potential causes of hospital readmission that can be identified and addressed to improve each patient's transition to outpatient care.
|
Usual Care Group (Control Arm)
n=249 Participants
Patients assigned to the Control Group receive standard discharge planning and follow-up per the usual care of their medical providers.
|
|---|---|---|
|
Patient Satisfaction: Hospital Experience (Top Box Rating)
|
155 Participants
|
173 Participants
|
SECONDARY outcome
Timeframe: Within 60 days of DischargePopulation: Patient experience data were retrieved from the hospital quality and patient safety office at 60 days, but assessment was administered via a survey sent to patients at their home after hospital discharge. Scores are based on the number of surveys returned
Measured as mean Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction scores. Scale range is 0-3. Higher scores indicate more patient satisfaction.
Outcome measures
| Measure |
Phone Call Group (Intervention Arm)
n=227 Participants
Follow-up phone call program: Patients will receive the first call attempt within 72 hours of hospital discharge with a maximum of 3 call attempts by the study nurse made up until post-discharge day 7. The semi-structured script embedded within the program specific electronic health record Discharge Phone Call Starform is used to guide a conversation to obtain information on potential causes of hospital readmission that can be identified and addressed to improve each patient's transition to outpatient care.
|
Usual Care Group (Control Arm)
n=247 Participants
Patients assigned to the Control Group receive standard discharge planning and follow-up per the usual care of their medical providers.
|
|---|---|---|
|
Patient Satisfaction: Likelihood to Recommend the Facility
|
2.7 score on a scale
Standard Deviation .7
|
2.7 score on a scale
Standard Deviation .6
|
SECONDARY outcome
Timeframe: 30 daysAll cause ED visits following discharge
Outcome measures
| Measure |
Phone Call Group (Intervention Arm)
n=1534 Participants
Follow-up phone call program: Patients will receive the first call attempt within 72 hours of hospital discharge with a maximum of 3 call attempts by the study nurse made up until post-discharge day 7. The semi-structured script embedded within the program specific electronic health record Discharge Phone Call Starform is used to guide a conversation to obtain information on potential causes of hospital readmission that can be identified and addressed to improve each patient's transition to outpatient care.
|
Usual Care Group (Control Arm)
n=1520 Participants
Patients assigned to the Control Group receive standard discharge planning and follow-up per the usual care of their medical providers.
|
|---|---|---|
|
VUMC Emergency Department (ED) Visits
|
93 ED visits
|
82 ED visits
|
SECONDARY outcome
Timeframe: 30 daysPopulation: Discharge plan implementation assistance was offered as part of the intervention and not to the control group.
Need for assistance in implementing discharge plan
Outcome measures
| Measure |
Phone Call Group (Intervention Arm)
n=1534 Participants
Follow-up phone call program: Patients will receive the first call attempt within 72 hours of hospital discharge with a maximum of 3 call attempts by the study nurse made up until post-discharge day 7. The semi-structured script embedded within the program specific electronic health record Discharge Phone Call Starform is used to guide a conversation to obtain information on potential causes of hospital readmission that can be identified and addressed to improve each patient's transition to outpatient care.
|
Usual Care Group (Control Arm)
Patients assigned to the Control Group receive standard discharge planning and follow-up per the usual care of their medical providers.
|
|---|---|---|
|
Number of Patient Received Discharge Plan Implementation Assistance
|
463 Participants
|
0 Participants
|
SECONDARY outcome
Timeframe: 30 daysPopulation: Thirty-day mortality data was retrieved from the EHR data repository after a 120-day lag to capture delayed reporting.
All cause mortality
Outcome measures
| Measure |
Phone Call Group (Intervention Arm)
n=1534 Participants
Follow-up phone call program: Patients will receive the first call attempt within 72 hours of hospital discharge with a maximum of 3 call attempts by the study nurse made up until post-discharge day 7. The semi-structured script embedded within the program specific electronic health record Discharge Phone Call Starform is used to guide a conversation to obtain information on potential causes of hospital readmission that can be identified and addressed to improve each patient's transition to outpatient care.
|
Usual Care Group (Control Arm)
n=1520 Participants
Patients assigned to the Control Group receive standard discharge planning and follow-up per the usual care of their medical providers.
|
|---|---|---|
|
Mortality
|
68 Participants
|
75 Participants
|
Adverse Events
Phone Call Group (Intervention Arm)
Serious events: 0 serious events
Other events: 0 other events
Deaths: 68 deaths
Usual Care Group (Control Arm)
Serious events: 0 serious events
Other events: 0 other events
Deaths: 75 deaths
Serious adverse events
Adverse event data not reported
Other adverse events
Adverse event data not reported
Additional Information
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place