Hospital Outcomes: Intervention in Moderately III Patients

Study Overview
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Brief Summary
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To evaluate the utility of real time prognostic data (illness severity, stability and function) in the improvement of hospitalization morbidity, mortality, iatrogenic complications and length of stay.

Detailed Description
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To evaluate resource allocation and efficiency of ancillary service delivery in aggregate cost and 3 month follow up in regards to hospital readmission, living environment, and utilization of social services. This is a randomized study which will compare the current Standard of Care in hospital to EARLY assessment and referrals with respect to social work services, rehabilitation, psychiatry, and nursing. In this study, the control group will receive the hospital support services provided under current system of delivery and allocation. The intervention group will not receive any new or different services not already provided to all patients at New York Presbyterian Hospital. The difference between the 2 groups will be the uniformity of screening to identify the needs of the patient in the respective area of social services, rehabilitation, psychiatric assistance, and nursing care, and the timeliness by which the referrals for support services will be placed. Potential interventions: (In both control and experimental group) Social work: Discharge planning (homecare, visiting nursing services, skilled nursing facility placement). Rehabilitation: Physical Therapy (improve ADLs-activities of daily living). Psychiatry: Diagnosis and Assistance in management of Depression. Nursing: Prevention of in hospital falls and decubitus ulcer formation.

Official Title
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Hospital Outcomes: Intervention in Moderately III Patients

Conditions
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Moderately Ill Medical Inpatients at the Cornell Campus of the New York-Presbyterian Hospital

Intervention / Treatment
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* Behavioral: Early assessment and referral to ancillary care services vs. standard care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All medical in-patients who are coded moderately ill with fair to poor function in the SIGNOUT program will be asked to participate in our study. Patients who are able to provide verbal consent for their participation will be enrolled. Exclusion Criteria: Any patient not coded in the SIGNOUT system as moderately ill with fair to poor function. Patients who refuses not to participate in the study. Patients who are unable to give written informed consent.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Intervention/Treatment |
| --- |
|Behavioral: Early assessment and referral to ancillary care services vs. standard care|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To evaluate the utility of real time prognostic data and in the improvement of hospitalization morbidity, mortality, iatrogenic complications, and length of stay. |  |  | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To evaluate resource allocation and efficiency of ancillary service delivery in aggregate cost and 3 month follow up in regards to hospital readmission, living environment, and utilization of social services. |  |  | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Medical inpatients, Social Work, Physical therapy, Occupational therapy, Psychiatry, Early intervention, Iatrogenic complications