Clinical Trials Logo

Clinical Trial Summary

This study aims to evaluate the THRIVE clinical pathway at HUP-Cedar, focusing on supporting Medicaid-insured individuals, including those with serious mental illness, following hospitalization. The study will assess clinician/administrator perspectives on the pathway's feasibility, appropriateness, and acceptability and analyze referral patterns and post-discharge outcomes. The objectives are: 1. To conduct a qualitative study evaluating the implementation of THRIVE, particularly its adaptation to include patients with serious mental illness. 2. To examine referral patterns, 30-day readmission rates, and ED utilization for THRIVE participants, comparing them with those receiving standard care. Participants will be referred to home care services during hospitalization and seen by a home care nurse within 48 hours post-discharge. A discharging physician or Advanced Practice Provider will oversee care for 30 days or until a primary care or specialist visit. The Care Coordination Team will hold weekly case conferences for 30 days post-discharge to address both health and mental health needs. The study will compare outcomes of Medicaid-insured patients, including those with serious mental illness, to those receiving usual care.


Clinical Trial Description

Detailed Description: This study is a single-site Type 1 hybrid effectiveness-implementation parallel mixed methods (quantitative + qualitative) quasi-experimental study at HUP-Cedar, focusing on the THRIVE clinical pathway. It integrates simultaneous quantitative and qualitative data collection and analysis, with a stronger emphasis on quantitative data to evaluate referrals, outcomes, and program fidelity. The qualitative aspect will explore the implementation process, delving into the barriers and facilitators encountered by healthcare providers. It will also assess stakeholder perspectives on the intervention's impact on health inequities among Medicaid-insured individuals in both acute and home care settings. By nesting qualitative interviews within a quasi-experimental framework, the study aims to examine the intervention's effect on primary outcomes (homecare referrals, 30-day readmission, ED utilization, connection to PCP) and to identify professional and organizational barriers to its implementation. The combination of effectiveness data with contextual insights will inform understanding of factors critical to THRIVE's implementation and outcomes. Qualitative Study: The recruitment process is meticulously managed to track each participant's journey. Recruitment begins in early January, with participants contacted via email, providing study details and interview scheduling links. Follow-up reminders ensure participant engagement. Interviews, conducted virtually and recorded with consent, focus on maintaining confidentiality and privacy. Non-consented sessions are captured through detailed notes. Post-interview, recordings are transcribed for analysis, enabling categorization into codes and themes for a deeper understanding of participant perspectives. Quantitative Study: Employing a stepped wedge design, the study would begin early March and would involve a randomized training of case managers at HUP-Cedar over several months. Initially, a subset of case managers receives training on the THRIVE pathway and starts offering referrals. After 8 weeks, the remaining case managers are trained and begin making referrals. This staggered approach allows for evaluation of the THRIVE intervention's rollout and its impact on patient care and outcomes. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT06203509
Study type Interventional
Source University of Pennsylvania
Contact Jacqueline M Brooks Carthon, PhD,RN
Phone 2158988050
Email jmbrooks@nursing.upenn.edu
Status Recruiting
Phase N/A
Start date April 15, 2024
Completion date October 1, 2026

See also
  Status Clinical Trial Phase
Not yet recruiting NCT05897125 - Telehealth Education Leveraging Electronic Transitions Of Care for COPD Patients N/A
Completed NCT02979353 - A Randomized Controlled Trial to Deprescribe for Older Patients With Polypharmacy N/A
Completed NCT05245773 - MORE-PC: A 30-day Automated SMS Program to Support Post-discharge Transitions of Care N/A
Enrolling by invitation NCT05714605 - Implementation and Evaluation of A Health Innovation to Support Medicaid-Insured Individuals Following Hospitalization N/A
Not yet recruiting NCT06309875 - Effect of the PLAN CUIDARTE on the Caregiving Competence of People With Heart Failure Phase 2
Completed NCT02354482 - Achieving Patient-Centered Care and Optimized Health In Care Transitions by Evaluating the Value of Evidence
Completed NCT04460742 - CAPABLE Transitions: A Home Health-Based Intervention for the Hospital or Post-Acute Care Facility-to-Home Transition N/A
Completed NCT03683797 - Testing the Efficacy of a Post-discharge Call Program on the Rate of Readmission N/A