Patient Oriented Discharge Summary Impact Study (PODS)
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|ClinicalTrials.gov Identifier: NCT02673892|
Recruitment Status : Active, not recruiting
First Posted : February 4, 2016
Last Update Posted : October 19, 2018
|Condition or disease||Intervention/treatment||Phase|
|Congestive Heart Failure Chronic Obstructive Pulmonary Disease Pneumonia Hip Fracture Total Hip Replacement Total Knee Replacement||Other: Patient Oriented Discharge Summary||Not Applicable|
Show Detailed Description
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||760 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||Triple (Participant, Investigator, Outcomes Assessor)|
|Primary Purpose:||Supportive Care|
|Official Title:||The Impact of a Patient-Centered Discharge Summary (PODS) on Patient Experience and Health Outcomes Following Discharge: A Multicenter Randomized Controlled Trial|
|Actual Study Start Date :||February 2016|
|Actual Primary Completion Date :||August 2018|
|Estimated Study Completion Date :||March 2019|
The PODS intervention is administered during the discharge process which includes discharge teaching. In the acute settings, discharge teaching is provided by a nurse navigator, resident physician, or other members of the care team. In the rehabilitation setting, discharge teaching is provided by a multi-disciplinary team. PODS is used as a useful add-on to the usual discharge teaching process. The PODS form used during the study will be a fillable pdf. Members of the healthcare team will fill it out electronically, then print it out and give the paper to the patient. After the discharge teaching is finished, patients take the completed PODS home with them as a post-discharge reference and guide.
Other: Patient Oriented Discharge Summary
The PODS provides a written template for providers to engage patients and caregivers when reviewing important discharge instructions on medications, activity and diet restrictions, follow-up appointments and worrisome symptoms warranting emergency care. The PODS also uses plain and simple wording, large fonts, pictograms, and includes white space for patients to take notes and provides the option for translation of major headings into the most common spoken languages. As this will be a pragmatic design, we may make modifications to the process involved in completing the PODS, such as using pre-filled disease-specific information, if system processes and providers involved deem it more usable and feasible.
No Intervention: Usual Care
Patients randomized to this arm will receive usual discharge care. At UHN, this involves receiving a discharge summary with information pertaining to hospital course including investigations performed and medications used, as well as follow-up care suggested. It is intended to be, unlike PODS, a document for the primary care physician seeing the patient after discharge to refer to. As to discharge instructions provided for the patient, there is no standard procedure and sometimes follow-up instructions are included for the patient. Patient education may or may not be provided to the patient verbally by their nurse, resident, physician, or pharmacist. Moreover, follow-up with the primary care physician may be set up prior to or following discharge with the nurse navigator.
- Patient Experience Measure [ Time Frame: 72 hours post-discharge ]The primary outcome will be a binary composite of the proportion of patients who scored Yes or "Completely/Quite a Bit" to 4 out of 6 of the CIHI Patient Experience In-Patient Survey on transitions of care.
- medication adherence [ Time Frame: 30 and 90 days ]self-reported adherence to all medications
- diet adherence [ Time Frame: 30 and 90 days ]self-reported adherence to diet restrictions
- activity adherence [ Time Frame: 30 and 90 days ]self-reported adherence to activity restrictions
- appointment adherence [ Time Frame: 30 and 90 days ]self-reported adherence to scheduled appointments
- unscheduled utilization [ Time Frame: 30 and 90 days ]a binary composite outcome of any unscheduled visits to primary care physician, emergency room, readmission to hospital or death
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02673892
|Toronto General Hospital|
|Toronto, Ontario, Canada, M5G 2C4`|
|Principal Investigator:||Karen Okrainec, MD||UHN|
|Principal Investigator:||Howard B Abrams, MD||UHN|