Telehealth Nursing Intervention for Children With Complex Health Care Needs (CCHCN)
Condition: Unplanned Use of Health Care Services
Study type: Interventional
Phase: Phase 3

Summary: 
      The overall objective of this study is to evaluate the effectiveness of a telehealth care
      coordination and case management nursing intervention for children with complex special
      health care needs.
    

Detailed description: 
      Children with complex special health care needs are those children who have multiple,
      complex, chronic health conditions who require health and related services of a type or
      amount beyond that required by children generally. When these children are hospitalized, they
      receive services as part of an integrated system that provides centralized record keeping and
      care orders, clearly identified roles and methods of communication for health professionals
      involved in their care, an established method to obtain equipment and supplies, and regular
      monitoring of the child's condition. However, when the same child is cared for at home,
      services are often fragmented, and rarely accessed and delivered in a coordinated system. The
      task of coordinating services and sharing information between providers almost always becomes
      the responsibility of the parent or guardian. Families report that their greatest challenges
      are the stress of coordinating multiple providers, and the disconnect and lack of
      communication between services and providers. This study will address these issues, using an
      advanced practice nurse (APN) program of telehealth care coordination and case management in
      support of these families. Either the telephone or telephone plus interactive video are used
      by an advanced practice nurse to provide care coordination and case management. Goals of the
      program are to (1) reduce the number of crisis or unplanned uses of health care services and
      increase the number of non-crisis or planned health care service usage, (2) improve the QL
      (quality of life) for these children and their families, and (3) reduce the deficit between
      help needed and help received for the families in caring for these children. The study
      objective will be accomplished using a three armed randomized controlled trial. Children will
      be randomized into a control group receiving usual care that includes LPN (Licensed practical
      nurse)-delivered care coordination and RN (registered nurse)-delivered telephone triage, an
      intervention group receiving APN-delivered telephone care coordination and case management,
      and another intervention group receiving APN-delivered telephone + video care coordination
      and case management services. It is hypothesized that as the level of telehealth use in
      coordination and management increases the utilization of unplanned, or crisis, health care
      service utilization will decrease, that families will receive more of their needed care, and
      quality of life for the children and their families will improve
    

Intervention name(s): telehealth plus aprn triage
Intervention type(s): Other
Intervention description(s): aprn using either telephone or telephone plus video conferencing will provide triage for CCHCN
Other intervention name(s): APRN
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: triage; aprn; telehealth; CCHCN; advanced practice nurse; improve family quality of life; reduce unplanned use of health care services; telehealth triage intervention