Early Screen for Discharge Planning in Community Hospitals

Study Overview
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Brief Summary
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The purpose of this study is to determine the predictive performance of the Early Screen for Discharge Planning (ESDP) tool in a regional community hospital. The central hypothesis is that the ESDP differentiates between patients in a regional community hospital who would benefit from those who would not benefit from early discharge-planning intervention as measured by problems and unmet continuing care needs, quality of life, length of stay, and referrals to post-acute services.

Detailed Description
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Patients who are hospitalized for medical or surgical reasons who consent to the study will be screened within 24 hours of hospital admission using the Early Screen for Discharge Planning (ESDP). The ESDP is a four-item screening tool used to determine on admission which patients are likely to have complex discharge plans and could benefit from early engagement of discharge planning personnel. The ESDP yields a total score, and those with a score of 10 or greater are considered to have a high score and likely to have a complex discharge plan. Those with a score of 9 or below have a low score. The ESDP screen has been proven to be valid in large academic medical centers. This study will determine if the screen performs with the same validity in a small community hospital.

Official Title
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Validating Discharge Planning Decision Support in a Regional Community Hospital

Conditions
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Hospitalization

Intervention / Treatment
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* Other: Early Screen for Discharge Planning


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 years or older Able to read and speak English Returning home in the community after discharge Exclusion Criteria: Discharged to facility care Pregnant females

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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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| High ESDP Score<br>Patients with 10 or greater score on the Early Screen for Discharge Planning at the time of admission. | Other: Early Screen for Discharge Planning<br>* This screen is completed by a study coordinator within 24 hours of patient admission to the hospital. The screen measures four variables available from routine hospital admission clinical data (walking limitation, age, living alone prior to admission, and level of disability) that exhibit high sensitivity and specificity (AUC's were .82 and.84) in identifying patients who should receive targeted attention from a DP expert.<br>|
| Low ESDP Score<br>Patients with 9 or lower score on the Early Screen for Discharge Planning at the time of admission. | Other: Early Screen for Discharge Planning<br>* This screen is completed by a study coordinator within 24 hours of patient admission to the hospital. The screen measures four variables available from routine hospital admission clinical data (walking limitation, age, living alone prior to admission, and level of disability) that exhibit high sensitivity and specificity (AUC's were .82 and.84) in identifying patients who should receive targeted attention from a DP expert.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of problems reported after discharge, measured by the Problems After Discharge Questionnaire - English Version (PADQ-E) | A problem is defined as any worry, limitation, concern, or difficulty reported by the patient. The Problems After Discharge Questionnaire - English Version measures important patient factors often overlooked that contribute to poor post-acute recovery experience which are recognized as important factors likely to impact readmission. | 1 week after hospital discharge | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of unmet needs reported after discharge, measured by the Problems After Discharge Questionnaire - English Version (PADQ-E) | An unmet need is a need for help identified by the patient that is reported to be inadequately met. The Problems After Discharge Questionnaire - English Version measures important patient factors often overlooked that contribute to poor post-acute recovery experience which are recognized as important factors likely to impact readmission. | 1 week after hospital discharge | 
| Quality of life, measured by the EuroQoL-5D | The EuroQoL-5D (EQ-5D) is a standardized instrument for use as a measure of health out-come. Applicable to a wide range of health conditions and treatments, it provides a simple descriptive profile and a single index value for health status that can be used in the clinical and economic evaluation of health care. | 1 week after hospital discharge | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Discharge Planning, Decision Support