CI

At a glance

ClinicalIndex Comparison Record
N/ACompleted· 7,939 enrolled
Drug / intervention
Patient Communication and Care Management +5 morebehavioral
Likely dose
Not stated in record
Structured eligibility isn't available for this trial yet — see the full criteria in the Eligibility tab below.

Standardized by ClinicalIndex from the ClinicalTrials.gov record · verify against the source.

Search/NCT02354482
NCT02354482N/ACompleted

Achieving Patient-Centered Care and Optimized Health In Care Transitions by Evaluating the Value of Evidence

Mark Williams·observational·Posted Feb 3, 2015·Updated Nov 26, 2019

In Brief

An observational study evaluating Patient Communication and Care Management, Home-Based Trust, Plain Language, and Coordination, and 4 other interventions for Care Transitions. Completed, enrolled 7,939 participants across 1 site.

Detailed Summary

Funded by the Patient Centered Outcome Research Institute (PCORI), nationally recognized leaders in health care and research methods are partnering with patients and caregivers to evaluate the effectiveness of current efforts at improving care transitions and develop recommendations on best practices for patient-centered care transitions and guidance for spreading them across the U.S.

Study Details

Timeline

N/ACompletedFinished
201520162017201820192020202120222023202420252026
First PostedFeb 3, 2015
Enrollment StartMar 1, 2015
Primary CompletionApr 30, 2019
Study CompletionJun 30, 2019
TodayJul 2, 2026
Enrollment to primary: 4.2 yearsPosted 11.4 years ago

Interventions

Patient Communication and Care Managementbehavioral

Received the following Transitional Care strategies: 1. Helpful Health Care Contact OR Symptom Management 2. Post-discharge Care Consultation 3. Patient Goal/Preference Assessment 4. Plain Language Communication in Hospital 5. Plain Language Communication at Home 6. Transition Summary for Patients and Family Caregivers

Home-Based Trust, Plain Language, and Coordinationbehavioral

Received the following Transitional Care Strategies: 1. Transition Team 2. Home visits 3. Plain Language Communication at Home 4. Promote Trust at Home 5. Referral to Community Services 6. Follow-up Appointment

Hospital-Based Trust, Plain Language, and Coordinationbehavioral

Received the following Transitional Care Strategies: 1. Post-discharge care consultation 2. Identify High-Risk Patients and Intervene 3. Medication Reconciliation 4. Plain Language Communication in Hospital 5. Promote Trust in the Hospital 6. Transition Summary for Patients and Family Caregivers

Patient/Caregiver Assessment and Provider Information Exchangebehavioral

Received the following Transitional Care Strategies: 1. Patient Goal/Preference Assessment 2. Identify High-Risk Patients and Intervene 3. Timely Exchange of Critical Patient Information among Providers 4. Patient/Family Caregiver Transitional Care Needs Assessment

Assessment and Teach Backbehavioral

Received the following Transitional Care Strategies: 1. Post-discharge care consultation 2. Language Assessment 3. Teach Back for Information and Skills

Standard of Care (Reference)other

No specific Transitional Care Strategy