Clinical trial NCT05241951: Preventing Medication-Related Problems in Care Transitions to Skilled Nursing Facilities
Official title: Preventing Medication-Related Problems in Care Transitions to Skilled Nursing Facilities Using a Pharmacy Integrated Transitional Team
Study type: INTERVENTIONAL
Overall status: ACTIVE_NOT_RECRUITING
Phase: NA
Conditions: Care Transition
Keywords: Care Transition
Medication-Related Problems
Post-Acute Care
Skilled Nursing Facility
Hospital Systems
Medication Safety
Lead sponsor: University of Washington
Sponsor class: OTHER
Collaborators: name: Agency for Healthcare Research and Quality (AHRQ)
First posted: 2022-02-16
Enrollment: 5760
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Intervention model description: A parallel cluster-randomized controlled crossover trial design, with randomization occurring at the skilled nursing facility cluster level. The trial is conducted across four hospitals and 14 independent SNFs in Washington State. SNF's are stratified by patient volume before randomly assigned to either the PIT program or usual care.
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: The Pharmacy Integrated Transitions (PIT) program, utilizes a crossover randomized control design to evaluate the impact of a clinical pharmacist in decreasing medication related problems during a patient's transition from hospital to skilled nursing facility (SNF).

Detailed description: Standard hospital discharge processes (e.g. as recommended by the Joint Commission Center for Transforming Healthcare), include hospital staff completing a paper-based discharge summary and medication reconciliation form. To reduce the likelihood of medication-related problems during care transitions, the Pharmacy Integrated Transitions (PIT) program aims to improve the standard transition process by adding a coordinating transitional pharmacist to provide a structured synchronous "warm-handoff" between clinical teams at the hospital and the Skilled Nursing Facility, in addition to reconciling, adjusting, and monitoring medications during and after discharge from the hospital.

Eligibility criteria: Inclusion Criteria:

* 18 years of age and older
* patients receiving inpatient care at University of Washington Mountlake, University of Washington Northwest, Harborview, and Valley Medical Center hospitals to one of 14 collaborating SNF's on a day when the PIT program pharmacist is conducting the intervention

Exclusion Criteria:

* Under 18 years of age
* patients with a discharge on hospice care
* patients discharged on days that the pharmacist is not conducting the intervention

Primary outcomes:
measure: Medication Related Problems
timeFrame: 30 days post hospital discharge
Secondary outcomes:
measure: Death
timeFrame: 30 Days post hospital discharge
measure: Readmissions
timeFrame: 30 Days
Other outcomes:
Locations:
city: Seattle
country: United States
facility: University of Washington Health System
state: Washington
Study officials:
affiliation: University of Washington
name: Giana Davidson, MD, MPH
role: PRINCIPAL_INVESTIGATOR
References: