Improved Patient Handoffs to Prevent Sentinel Events

Health Care Quality Clinical Trial

Official title:

Patient Acuity Score With Improved Patient Handoffs to Prevent Sentinel Events

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01855646
• Other study ID #: Pro00044212
• Status: Completed
• Phase: N/A
• First received: May 14, 2013
• Last updated: November 23, 2016
• Est. completion date: January 2014

Study information

• Verified date: April 2014
• Source: Duke University
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Institutional Review Board
• Study type: Interventional

Clinical Trial Summary

The overall aim of this project is to improve the quality of the handoffs between hospitalists on the general medicine service at Durham Regional Hospital with the intent of improving transitions of care. The intervention will be an improved and more structured face to face sign-out process using a standardized admission sign-out sheet, which is not part of the official medical record. Daytime admitting physicians will assign an acuity score to their patients in which the severity of illness will be scored from 1-7, with 7 being the most sick / likely to have rapid response team (RRT) or adverse event. The assignment of this score would be based off of the clinician's judgment in the patient's overall assessment. All patients, age >18 years, admitted to the non-resident hospital medicine general medicine service at DRH will be study eligible. Data analysis will examine aggregate hospitalist perception of sign-out practice before and after intervention, total number of RRTs, unplanned transfers, and rapid responses pre and post intervention, percentage of hospitalist based patients of overall rapid responses pre and post intervention, percentage of hospitalists using acuity scores, and average and mean severity score of patients with rapid responses compared with those admitted. Patients have a risk of loss of confidentiality.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 4344
• Est. completion date: January 2014
• Est. primary completion date: January 2014
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• patients age >18 years

• admitted to the non-resident hospital medicine general medicine service at Durham Regional Hospital (DRH). (This would include transfers from outside hospital, the Emergency Room, intensive care units, and the Durham Rehab Institute.)

• Additionally, hospital medicine faculty who round on the non-resident general medicine service at DRH will be included for the purposes of completion of perception surveys.

Exclusion Criteria:

• Patients presenting for consults, rapid responses handled by surgical services and rapid responses as reason for transfer from Durham Rehabilitation Institute.

Study Design

Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Health Services Research

Related Conditions & MeSH terms

• Access and Evaluation
• Health Care Quality

Intervention

Other:
• Structured Sign Out Form

Locations

Country	Name	City	State
United States	Durham Regional Hospital	Durham	North Carolina

Sponsors (1)

Lead Sponsor	Collaborator
Duke University

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Compliance rate monthly with sign-out sheet completion; will use simple descriptive statistics		End of Study, Approximately 6 months	No
Primary	Comparison of RRT's and unplanned transfers pre and post intervention matching aggregate numbers month to month		End of Study, Approximately 6 months	No
Secondary	Physician attitudes towards sign-out process pre and post intervention		End of Study, Approximately 6 months	No