Identifying Adverse Events After Discharge From a Community Hospital
The purpose of this study is to:
-Determine the incidence of adverse events, preventable adverse events, and ameliorable adverse events, and the timeliness of post-discharge ambulatory appointments, affecting urban and rural patients approximately 3-4 weeks after discharge from a hospitalist-run medical service of a large community hospital to home.
H1: The incidence of post-discharge adverse events will be higher in rural patients compared with urban patients discharged from a hospitalist-run medical service of a large community hospital.
-Identify and classify the types of post-discharge adverse events (e.g., adverse drug events, procedure-related events, hospital acquired (nosocomial) infections, falls, and other) affecting urban and rural patients approximately 3-4 weeks after discharge from a hospitalist-run medical service of a large community hospital to home.
H2: All patients will be at higher risk for adverse drug events than other types of adverse events.
-Examine the relationships between the population at risk, characteristics of the health care delivery system, and the utilization of post-discharge health services, and how these relationships help us understand the incidence of post-discharge adverse events.
H3: Several factors will be independently associated with the incidence of post-discharge adverse events in rural and urban patients, including patient comorbidity, severity of acute illness, presence of a primary care physician prior to hospitalization, and a scheduled timely post-discharge ambulatory follow-up appointment.
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
|Official Title:||Identifying Adverse Events After Discharge From a Community Hospital|
- post discharge adverse event [ Time Frame: six weeks after discharge from the hospital ] [ Designated as safety issue: Yes ]Patients are contacted 3-6 weeks after discharge for a phone interview. They are questioned about potential adverse events following their discharge from the hospital. Interviewers/nurses conduct a review of systems to determine if the patient experienced an adverse event. Potential cases are flagged on the basis of unexpected health care utilization, new/exacerbated symptoms and/or abnormal lab test results. Cases are reviewed by two independent physician reviewers to determine whether the adverse event was preventable, using their implicit judgment.
|Study Start Date:||September 2011|
|Study Completion Date:||October 2014|
|Primary Completion Date:||October 2012 (Final data collection date for primary outcome measure)|
Please refer to this study by its ClinicalTrials.gov identifier: NCT01536340
|United States, Florida|
|Tallahassee Memorial Healthcare|
|Tallahassee, Florida, United States, 32301|
|Principal Investigator:||Dennis Tsilimingras, MD, MPH||Wayne State University|
|Study Director:||Ashley Duke||Florida State University College of Medicine|