Collaborative Healthcare Professionals Approach in Monitoring of Patient Centered Outcomes Through Pathways

Asthma Clinical Trial

— CHAMP-Path  

Official title:

A Pragmatic Randomized Controlled Trial of Patient-Centered Integrated Clinical Pathways Based Versus Usual Care in an Academic Center: National Guard Health Affairs Western Region Experience

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01561885
• Other study ID #: RC 10/134/J
• Status: Completed
• Phase: N/A
• First received: March 18, 2012
• Last updated: April 4, 2017
• Start date: March 2012
• Est. completion date: March 2016

Study information

• Verified date: April 2017
• Source: King Abdullah International Medical Research Center
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The aim of this study is to determine if by providing a collaborative, integrated pathway-based healthcare compared to the usual healthcare, whether or not this would be superior in reducing the length of hospital stay across five high frequency /high risk medical diagnoses: Acute Venous Thromboembolism, Acute Kidney Injury, Community Acquired Pneumonia, Adult Left Ventricular Heart Failure, and Asthma.

Description:

This study is a pragmatic randomized controlled trial. To date, there is a scarcity of randomized controlled trials looking at pathway-based, patient-centered healthcare versus usual care in several high-risk or high volume diagnoses that account for the vast majority of hospitalizations in medical settings.

In this study, the pathway care intervention is a collaborative effort that involves healthcare professionals from multiple departments, including pharmacists, health educators, nurses, social workers, nutritionists, and quality management.

For patients allocated to the usual care, these healthcare professionals will deliver standardized care when consulted. For pathway care patients, this collaborative healthcare will be default.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 341
• Est. completion date: March 2016
• Est. primary completion date: March 2016
• Accepts healthy volunteers: No
• Gender: All
• Age group: 14 Years and older

Eligibility

1. Inclusion Criteria (Overall Criteria):

• One principle diagnosis

• Hemodynamic Stability

2. Inclusion Criteria (Specific to each Diagnosis):

Acute Venous Thromboembolism:

• New onset / in-patient

Acute Kidney Injury:

• Patients with increased serum creatinine of more than 50% from baseline

Community Acquired Pneumonia:

• Age limit

Adult Left Ventricular Heart Failure:

• Age limit

Asthma

• Acute exacerbation of Asthma

3. Exclusion Criteria (Overall Criteria):

• Intensive Care Unit (ICU) patients

• Pregnancy

4. Exclusion Criteria (Specific to each Diagnosis):

Acute Venous Thromboembolism:

• Hemodynamic instability (Systolic Blood Pressure (SBP) less than 90 mmHg or massive Pulmonary Embolism (PE)

• PE patients with an sPESI Score = 1

Acute Kidney Injury:

• Critical care patients (ICU, Coronary Care Unit, burn units)

• Stage 4 and 5 chronic kidney diseases

• Kidney allograft recipients

• Obstructive uropathy

• Glomerulonephritis

• Interstitial nephritis

Community Acquired Pneumonia:

• Intensive Care Unit (ICU) patients

• Pregnancy

Adult Left Ventricular Heart Failure:

• All non-cardiogenic pulmonary edema

• Patients requiring Inotropic agents

Asthma

• Patients with Chronic Obstructive Pulmonary Disease (COPD) and Bronchiectasis

• Severe Asthma (Peak Expiratory Flow Rate (PEFR) less than 40 percent)

Related Conditions & MeSH terms

• Acute Kidney Injury
• Asthma
• Community Acquired Pneumonia
• Heart Failure
• Pneumonia
• Thromboembolism
• Venous Thromboembolism

Intervention

Other:
• Pathway-Based Care
Patients who are randomly allocated to Pathway Care will be treated by the Pathway Clinical Teaching Unit as well as other collaborative healthcare professionals (pharmacists, nurses, health educators, nutritionists, and social workers). The Pathway Care physicians will have access to the Clinical Care Plan on the QuadraMed, which is a detailed, organized, day-to-day treatment plan that includes pre-set orders and medications. Physicians for the patients on Usual Care will not have access to this information, and the collaborative healthcare will only be provided upon consultation.

Locations

Country	Name	City	State
Saudi Arabia	King Khalid National Guard Hospital	Jeddah	Makkah

Sponsors (1)

Lead Sponsor	Collaborator
Majed Aljeraisy

Country where clinical trial is conducted

Saudi Arabia, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Decrease in length of hospital stay by two days		During hospitalization period of 7 to 10 days
Secondary	30-Day Rehospitalization	To determine the effect of the pathway-based care versus usual care on 30-day rehospitalization rates for the same diagnosis	After discharge up to 30 days
Secondary	Determinants of the Length of Stay		Upon admission until discharge
Secondary	Pathway Care Specific Clinical Outcomes	For pathway care, there are specific targeted outcomes that ought to be met.	Upon admission until discharge