Community Health Services Clinical Trial
— ATDOM_SPOfficial title:
Map of Risks in Home Care From Primary Health Care.
Background: Home health care is very complex. The registration of many disassembled information makes it difficult to interpret and does not allow the identification of critical areas for risk management. Hypothesis / Research question: The availability of a risk map, with visual alerts to identify the critical areas, will facilitate the implementation of safe practices and improve the safety of patients included in the DOMicillary care program (ATDOM). Objectives: To design and evaluate the effectiveness of the availability of a Visual Risks Map (MRV) in the computerized medical histories of ATDOM patients in the improvement of their safety and quality of life.(QL). Methods: Once MRV is designed, the investigators will conduct a randomized clinical trial by conglomerates (Primary Care centers) to evaluate whether the fact of having this MRV (intervention) in the medical histories of ATDOM patients reduces avoidable income, falls and wounds and improves QL. Analysis plan: Baseline description: socio-demographic characteristics, risk's levels in the different areas and other covariates in the control and intervention groups. Chi-square test to compare frequency of outcomes between control and intervention groups. Cox regression model to estimate time until the outcomes appear, adjusting for the different variables. Expected results: The frequency of avoidable hospital admissions / emergencies' visits, falls and sores / infections will be significantly lower in the group of patients who have MRV in their clinical histories. Their qL wil be better. Applicability and Relevance: It is a feasible and easy-to-implement project. It provides a practical utility for a lot of information that the investigators record and affects a key aspect of quality of care.
Status | Not yet recruiting |
Enrollment | 400 |
Est. completion date | December 31, 2025 |
Est. primary completion date | June 1, 2025 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - patients included in the primary care home care program Exclusion Criteria: - refusal of the patient to participate in the study |
Country | Name | City | State |
---|---|---|---|
Spain | IDIAP Jordi Gol | Barcelona |
Lead Sponsor | Collaborator |
---|---|
Fundacio d'Investigacio en Atencio Primaria Jordi Gol i Gurina | Institut Català de la Salut |
Spain,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Modification of the number of visits to hospital centers, emergency consultations, falls, sores and infections of the study participants. | Data will be collected in relation to the number of hospital visits and emergency visits to calculate avoidable visits. Events such as falls, the presence of sores and / or infections of the study participants will be compiled, taking into account their inclusion in the intervention group or control group to which they have been assigned. The data will be extracted from the clinical history (eCAP) according to the corresponding diagnosis. | 1 year | |
Secondary | Rate of admissions and visits to preventable hospital emergencies | Calculation of the rate of preventable hospital admissions and hospital visits in patients included in the ATDOM program. The number of visits to hospital centers and the number of visits to the emergency services as recorded in the medical record (eCAP) will be recorded. | 1 year | |
Secondary | Infections and sores | Frequency of infections and / or sores in patients included in the ATDOM program according to their inclusion in the control or intervention group. The corresponding diagnosis will be taken into account according to the medical record (eCAP). | 1 year | |
Secondary | Quality of live in ATDOM patients | Modification in the quality of life in the patients included in the ATDOM program according to their inclusion in the intervention or control group. Quality of life will be assessed according to the EuroQol-5D index (validated questionnaire) | 1 year | |
Secondary | Sores, falls, hospital admissions, final institutionalization and death. | Register of sores, falls, hospital admissions, institutionalization and registered deaths of the participants according to intervention or control group. The data will be collected according to registration in the clinical history (eCAP) through corresponding diagnoses. | 1 year | |
Secondary | Risk management in ATDOM patients | Changes in risk management in patients with ATDOM through the implementation of safe practices based on the rapid identification and prioritization of critical areas through a visual risk map. For the evaluation of this indicator, the implementation of nursing care plans will be quantified. The implementation of nursing care plans orients towards prevention measures and improving the quality of care. Nursing care plans are a tool available in the medical record (eCAP) from which preventive activities and care based on clinical evidence can be established. | 1 year |
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