Ignite Creation Date:
2024-05-06 @ 8:27 PM
Last Modification Date:
2024-10-26 @ 3:28 PM
Study NCT ID:
NCT06387576
Status:
RECRUITING
Last Update Posted:
2024-04-29
First Post:
2024-04-08
Brief Title:
Post-Discharge Follow-up Appointment Scheduling
Sponsor:
University of California Los Angeles
Organization:
University of California Los Angeles
Study Overview
Official Title:
Post-Discharge Follow-up Appointment Scheduling
Status:
RECRUITING
Status Verified Date:
2024-04
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
This is a prospective clinical trial evaluating whether a behaviorally informed intervention pre-discharge iPad video scheduling increases post-discharge primary care physician PCP appointment completion compared to the status-quo scheduling process post-discharge via phone with the ultimate goal of improving patient health outcomes
Detailed Description:
Among patients who are discharged from hospitals having a PCP follow-up visit within 7 days of discharge is associated with decreased likelihood of unplanned readmissions However at UCLA Health less than 60 of patients complete a PCP follow-up visit within this time period
As part of a Department of Medicine DOM quality improvement initiative at UCLA Health this trial seeks to improve the process of scheduling post-discharge PCP visits and in turn post-discharge PCP visit completion rates The DOM quality team initiated and is leading this program with the primary goal to improve the quality of post-acute care among patients In order to rigorously assess the most effective way to improve the process of scheduling post-discharge PCP visits the DOM quality team has partnered with the UCLA Anderson School of Management
This study will compare two types of appointment scheduling processes
the status quo scheduling process whereby a scheduler calls patients after discharge via telephone to schedule a PCP appointment
an iPad-based video scheduling process whereby patients will schedule their PCP appointment before discharge via a video call with the scheduler using an in-room iPad
Patients discharged from UCLA Health hospital rooms assigned to the control condition will go through the status quo scheduling process and patients discharged from rooms assigned to the intervention condition will go through the iPad-based video scheduling process
Patients who meet the following criteria will be included in the study 1 they are discharged from a hospital room assigned to either the intervention or control condition during the intervention period 2 their discharge is ordered on a weekday Monday-Friday 3 their discharge is planned before 3pm 4 they have a UCLA PCP 5 they are not being discharged to a skilled nursing facility SNF acute rehab unit ARU or assisted living facility ALF Patients will be excluded from the study who do not meet these criteria
The target sample size is n 150 in the treatment group The investigators have an agreement from their field partner to run the evaluation for one month The investigators will aim to extend the period in 2-week increments until the target sample size is reached The investigators note that this is subject to field partner agreement The investigators will also plan to have a check-in period with the schedulers during the first week of the intervention to assess whether any changes to the protocol or script need to occur for unforeseen logistical reasons
Two out of approximately ten DOM schedulers will be trained on the new iPad-based scheduling procedure hereafter the intervention schedulers As their time allows the two intervention schedulers will also continue to schedule post-discharge follow-up appointments using the status quo method phone calls for patients who are not discharged from the intervention rooms
Analysis Plan
The investigators will use patient-level linear regression models with a difference-in-differences design where the predictor variables are 1 an indicator of the treatment vs control rooms 2 an indicator of being in the intervention period vs three months pre-intervention or the length of the intervention period whichever is longer and 3 the interaction between the two indicators If an outcome measure does not statistically significantly differ between treatment and control rooms during the pre-intervention period the investigators will also compare the outcome measures between treatment and control patients using an OLS regression with observations from the intervention period
Given the possibility that the two intervention schedulers might conduct some scheduling calls for patients in a control room using the status-quo scheduling process post-discharge via phone the investigators will conduct all primary and secondary analyses excluding patients in the control condition who were scheduled by an intervention scheduler to minimize contamination
In addition to primary and secondary outcome measures listed later the investigators also plan to explore whether the patient experienced an unplanned readmission all-cause to the hospital within 7 14 and 30 days The investigators will plan to only analyze hospital readmission data if greater than 01 of patients across both arms have been readmitted during each respective period
Control variables to be included in regressions
Risk for readmission score LACE score
Patient self-reported ethnicity
Scheduler fixed effects
Whether patient had been enrolled in intensive care coordination programs
Whether patient had a pre-existing PCP appointment at the time of hospital admission
As part of a Department of Medicine DOM quality improvement initiative at UCLA Health this trial seeks to improve the process of scheduling post-discharge PCP visits and in turn post-discharge PCP visit completion rates The DOM quality team initiated and is leading this program with the primary goal to improve the quality of post-acute care among patients In order to rigorously assess the most effective way to improve the process of scheduling post-discharge PCP visits the DOM quality team has partnered with the UCLA Anderson School of Management
This study will compare two types of appointment scheduling processes
the status quo scheduling process whereby a scheduler calls patients after discharge via telephone to schedule a PCP appointment
an iPad-based video scheduling process whereby patients will schedule their PCP appointment before discharge via a video call with the scheduler using an in-room iPad
Patients discharged from UCLA Health hospital rooms assigned to the control condition will go through the status quo scheduling process and patients discharged from rooms assigned to the intervention condition will go through the iPad-based video scheduling process
Patients who meet the following criteria will be included in the study 1 they are discharged from a hospital room assigned to either the intervention or control condition during the intervention period 2 their discharge is ordered on a weekday Monday-Friday 3 their discharge is planned before 3pm 4 they have a UCLA PCP 5 they are not being discharged to a skilled nursing facility SNF acute rehab unit ARU or assisted living facility ALF Patients will be excluded from the study who do not meet these criteria
The target sample size is n 150 in the treatment group The investigators have an agreement from their field partner to run the evaluation for one month The investigators will aim to extend the period in 2-week increments until the target sample size is reached The investigators note that this is subject to field partner agreement The investigators will also plan to have a check-in period with the schedulers during the first week of the intervention to assess whether any changes to the protocol or script need to occur for unforeseen logistical reasons
Two out of approximately ten DOM schedulers will be trained on the new iPad-based scheduling procedure hereafter the intervention schedulers As their time allows the two intervention schedulers will also continue to schedule post-discharge follow-up appointments using the status quo method phone calls for patients who are not discharged from the intervention rooms
Analysis Plan
The investigators will use patient-level linear regression models with a difference-in-differences design where the predictor variables are 1 an indicator of the treatment vs control rooms 2 an indicator of being in the intervention period vs three months pre-intervention or the length of the intervention period whichever is longer and 3 the interaction between the two indicators If an outcome measure does not statistically significantly differ between treatment and control rooms during the pre-intervention period the investigators will also compare the outcome measures between treatment and control patients using an OLS regression with observations from the intervention period
Given the possibility that the two intervention schedulers might conduct some scheduling calls for patients in a control room using the status-quo scheduling process post-discharge via phone the investigators will conduct all primary and secondary analyses excluding patients in the control condition who were scheduled by an intervention scheduler to minimize contamination
In addition to primary and secondary outcome measures listed later the investigators also plan to explore whether the patient experienced an unplanned readmission all-cause to the hospital within 7 14 and 30 days The investigators will plan to only analyze hospital readmission data if greater than 01 of patients across both arms have been readmitted during each respective period
Control variables to be included in regressions
Risk for readmission score LACE score
Patient self-reported ethnicity
Scheduler fixed effects
Whether patient had been enrolled in intensive care coordination programs
Whether patient had a pre-existing PCP appointment at the time of hospital admission
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None