Integrative hospital treatment in older patients to benchmark and improve outcome and length of stay - the In-HospiTOOL study.
Adolescent
Adult
Aged
Benchmarking
/ standards
Clinical Trials as Topic
Comparative Effectiveness Research
Delivery of Health Care
/ statistics & numerical data
Delivery of Health Care, Integrated
/ standards
Hospitalization
/ statistics & numerical data
Humans
Interprofessional Relations
Length of Stay
/ statistics & numerical data
Middle Aged
Multicenter Studies as Topic
Multiple Chronic Conditions
/ therapy
Patient Discharge
/ standards
Patient Readmission
/ standards
Patient Transfer
/ standards
Pragmatic Clinical Trials as Topic
Prospective Studies
Quality of Health Care
Resource Allocation
Young Adult
Clinical outcomes
Discharge planning
Health services research
Integrated care
Interprofessional
Length of hospital stay
Polymorbidity
Readmission
Resource allocation
Transition
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
23 Apr 2019
23 Apr 2019
Historique:
received:
04
11
2018
accepted:
27
03
2019
entrez:
25
4
2019
pubmed:
25
4
2019
medline:
18
6
2019
Statut:
epublish
Résumé
A comprehensive in-hospital patient management with reasonable and economic resource allocation is arguably the major challenge of health-care systems worldwide, especially in elderly, frail, and polymorbid patients. The need for patient management tools to improve the transition process and allocation of health care resources in routine clinical care particularly for the inpatient setting is obvious. To address these issues, a large prospective trial is warranted. The "Integrative Hospital Treatment in Older patients to benchmark and improve Outcome and Length of stay" (In-HospiTOOL) study is an investigator-initiated, multicenter effectiveness trial to compare the effects of a novel in-hospital management tool on length of hospital stay, readmission rate, quality of care, and other clinical outcomes using a time-series model. The study aims to include approximately 35`000 polymorbid medical patients over an 18-month period, divided in an observation, implementation, and intervention phase. Detailed data on treatment and outcome of polymorbid medical patients during the in-hospital stay and after 30 days will be gathered to investigate differences in resource use, inter-professional collaborations and to establish representative benchmarking data to promote measurement and display of quality of care data across seven Swiss hospitals. The trial will inform whether the "In-HospiTOOL" optimizes inter-professional collaboration and thereby reduces length of hospital stay without harming subjective and objective patient-oriented outcome markers. Many of the current quality-mirroring tools do not reflect the real need and use of resources, especially in polymorbid and elderly patients. In addition, a validated tool for optimization of patient transition and discharge processes is still missing. The proposed multicenter effectiveness trial has potential to improve interprofessional collaboration and optimizes resource allocation from hospital admission to discharge. The results will enable inter-hospital comparison of transition processes and accomplish a benchmarking for inpatient care quality.
Sections du résumé
BACKGROUND
BACKGROUND
A comprehensive in-hospital patient management with reasonable and economic resource allocation is arguably the major challenge of health-care systems worldwide, especially in elderly, frail, and polymorbid patients. The need for patient management tools to improve the transition process and allocation of health care resources in routine clinical care particularly for the inpatient setting is obvious. To address these issues, a large prospective trial is warranted.
METHODS
METHODS
The "Integrative Hospital Treatment in Older patients to benchmark and improve Outcome and Length of stay" (In-HospiTOOL) study is an investigator-initiated, multicenter effectiveness trial to compare the effects of a novel in-hospital management tool on length of hospital stay, readmission rate, quality of care, and other clinical outcomes using a time-series model. The study aims to include approximately 35`000 polymorbid medical patients over an 18-month period, divided in an observation, implementation, and intervention phase. Detailed data on treatment and outcome of polymorbid medical patients during the in-hospital stay and after 30 days will be gathered to investigate differences in resource use, inter-professional collaborations and to establish representative benchmarking data to promote measurement and display of quality of care data across seven Swiss hospitals. The trial will inform whether the "In-HospiTOOL" optimizes inter-professional collaboration and thereby reduces length of hospital stay without harming subjective and objective patient-oriented outcome markers.
DISCUSSION
CONCLUSIONS
Many of the current quality-mirroring tools do not reflect the real need and use of resources, especially in polymorbid and elderly patients. In addition, a validated tool for optimization of patient transition and discharge processes is still missing. The proposed multicenter effectiveness trial has potential to improve interprofessional collaboration and optimizes resource allocation from hospital admission to discharge. The results will enable inter-hospital comparison of transition processes and accomplish a benchmarking for inpatient care quality.
Identifiants
pubmed: 31014343
doi: 10.1186/s12913-019-4045-x
pii: 10.1186/s12913-019-4045-x
pmc: PMC6480877
doi:
Types de publication
Clinical Trial Protocol
Journal Article
Personal Narrative
Langues
eng
Sous-ensembles de citation
IM
Pagination
237Subventions
Organisme : Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
ID : 407440_167376
Organisme : Research council of the Kantonsspital Aarau
ID : 1410.000.086
Organisme : Wissenschaft & Weiterbildung (W&W) Fonds of the Kantonsspital Aarau
ID : 140.000.495
Organisme : Hugo und Elsa Isler Fonds of the Argovian Department of Health and Social Affairs
ID : Not applicable
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