Department of Cardiovascular Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.
The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College Geisel School of Medicine, Hanover, New Hampshire, USA.
Open Heart. 2019 Jul 11;6(2):e001062. doi: 10.1136/openhrt-2019-001062. eCollection 2019.
Ineffective hospital discharge communication can significantly impact patient understanding, safety and treatment adherence. This may be especially true for cardiology inpatients who leave the hospital with complex discharge plans delivered in a time-pressured discharge discussion. The goal of this pilot trial was to determine if providing supplemental audio-recorded discharge instructions is feasible and to explore its impact on cardiology patients' ability to understand and self-manage their care .
We will conduct a parallel-group, randomised controlled trial in adult cardiology inpatients with balanced blocking by a physician. Patients (n=50) will be randomised to usual care (verbal discussion and written summary) or intervention (usual care, plus audio-recorded discharge discussion provided to patients on a portable electronic recording device). Enrolled patients will complete study assessments immediately prior to the discharge discussion, immediately postdischarge discussion and 1 week after hospital discharge by telephone. Primary outcomes include the proportion of eligible providers and inpatients who agree to take part in the trial, the proportion of inpatients who receive the audio recording in accordance with a fidelity checklist, and the proportion who use the audio recording. We will analyse preliminary data about the impact of audio recording on patient activation, health confidence, provider communication ability, adherence and 30-day readmissions.
This trial was approved by The Committee for the Protection of Human Subjects (CPHS) at Dartmouth College (CPHS# 00031211). Findings will be disseminated in scientific journals and at meetings.
NCT03735342.
1.0.
无效的医院出院沟通可能会严重影响患者的理解、安全和治疗依从性。对于心内科住院患者来说,这种情况尤其如此,他们在时间紧迫的出院讨论中收到了复杂的出院计划。本试验的目的是确定提供补充的音频出院指导是否可行,并探讨其对心内科患者理解和自我管理护理的能力的影响。
我们将在成年心内科住院患者中进行一项平行组、随机对照试验,采用医师平衡分组。患者(n=50)将随机分为常规护理(口头讨论和书面总结)或干预组(常规护理,外加向患者提供便携式电子记录设备上的音频出院讨论)。入组患者将在出院讨论前、出院讨论后立即和出院后 1 周通过电话完成研究评估。主要结局包括合格的提供者和住院患者同意参与试验的比例、住院患者按照保真度检查表接受音频记录的比例以及使用音频记录的比例。我们将分析关于音频记录对患者激活、健康信心、提供者沟通能力、依从性和 30 天再入院率的影响的初步数据。
该试验已获得达特茅斯学院保护人类受试者委员会(CPHS)的批准(CPHS#00031211)。研究结果将在科学期刊和会议上发表。
NCT03735342。
1.0。