Patient Readmission Clinical Trial
— FAMFACESGRCTOfficial title:
Impact of Implementing a Real Time Frequent Admitter Risk Score (FAM-FACE-SG) on Readmission Rates: a Pragmatic Cluster Randomised Controlled Trial (RCT).
Verified date | April 2023 |
Source | Singapore General Hospital |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
In an earlier study using electronic health records (EHR), the investigators have identified nine factors to be significantly associated with FA risk. These nine predictors include Furosemide intravenous 40 milligrams or more; Admissions in the past one year; Medifund status; Frequent emergency department use; Anti-depressants treatment in past one year; Charlson comorbidity index; End Stage Renal Failure on dialysis; Subsidized ward stay and Geriatric patient. The investigators have combined these nine predictors into the FAM-FACE-SG score for FA risk (defined as 3 or more inpatient admissions in the following 12 months). The FAM-FACE-SG risk score has the advantage of being deployed in our hospital's enterprise data repository known as Electronic Health Intelligence System or eHINTs for short, on a real-time or near real-time basis. On a daily basis, data from multiple data sources are extracted, transformed and loaded onto the eHINTS system. The system can be programmed to run every midnight to provide risk scores the following morning for patients admitted the previous day. In this trial, the intervention is to combine the FAM-FACE-SG risk score in addition to a decision making algorithm to guide referrals to various transitional care services based on needs assessment on nursing and function. The primary objective is to evaluate the impact of our intervention in improving healthcare utilization (hospital readmissions, emergency department (ED) attendances, length of stay up to 90 days post-discharge).
Status | Withdrawn |
Enrollment | 0 |
Est. completion date | August 2017 |
Est. primary completion date | August 2017 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 21 Years and older |
Eligibility | Inclusion Criteria: - Singapore General Hospital wards with patient navigators - Patients who are frequent admitters (defined as 3 or more hospital admissions in the preceding 12 months) Exclusion Criteria: - Haematology, Oncology, Emergency department, obstetrics and neonatology wards |
Country | Name | City | State |
---|---|---|---|
Singapore | Singapore General Hospital | Singapore |
Lead Sponsor | Collaborator |
---|---|
Singapore General Hospital |
Singapore,
Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med. 2009 Apr 2;360(14):1418-28. doi: 10.1056/NEJMsa0803563. Erratum In: N Engl J Med. 2011 Apr 21;364(16):1582. — View Citation
Kripalani S, Theobald CN, Anctil B, Vasilevskis EE. Reducing hospital readmission rates: current strategies and future directions. Annu Rev Med. 2014;65:471-85. doi: 10.1146/annurev-med-022613-090415. Epub 2013 Oct 21. — View Citation
Longman JM, I Rolfe M, Passey MD, Heathcote KE, Ewald DP, Dunn T, Barclay LM, Morgan GG. Frequent hospital admission of older people with chronic disease: a cross-sectional survey with telephone follow-up and data linkage. BMC Health Serv Res. 2012 Oct 30 — View Citation
Low LL, Vasanwala FF, Ng LB, Chen C, Lee KH, Tan SY. Effectiveness of a transitional home care program in reducing acute hospital utilization: a quasi-experimental study. BMC Health Serv Res. 2015 Mar 14;15:100. doi: 10.1186/s12913-015-0750-2. — View Citation
Robst J. Developing Models to Predict Persistent High-Cost Cases in Florida Medicaid. Popul Health Manag. 2015 Dec;18(6):467-76. doi: 10.1089/pop.2014.0174. Epub 2015 Jun 23. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | 90-day readmission rate | 90 days | ||
Secondary | 30-day readmission rate | 30 days | ||
Secondary | 30-day ED attendance rate | 30 days | ||
Secondary | 90-day ED attendance rate | 90 days | ||
Secondary | index hospital admission length of stay | 90 days | ||
Secondary | cumulative length of stay 90 days after index hospital discharge | 90 days | ||
Secondary | Fidelity of the PNs in following the protocol in recruiting patients according the score priority | 90 days | ||
Secondary | Proportion of high and medium risk patients recruited in both intervention and control groups | 90 days | ||
Secondary | Referral rate of the PNs to various transitional care services | 90 days | ||
Secondary | Qualitative feedback from PNs on the perceived benefits and behaviour change after receiving the scores | Questionnaire survey | 1 year |
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