Effect of hospital-at-home vs. traditional brick-and-mortar hospital care in acutely ill adults: study protocol for a pragmatic randomized controlled trial
Abstract Background Delivering acute hospital care to patients at home might reduce costs and improve patient experience. Mayo Clinic’s Advanced Care at Home (ACH) program is a novel virtual hybrid model of “Hospital at Home.” This pragmatic randomized controlled non-inferiority trial aims to compar...
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | Trials |
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| Online Access: | https://doi.org/10.1186/s13063-022-06430-6 |
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| author | Xiaoxi Yao Margaret Paulson Michael J. Maniaci Ajani N. Dunn Chad R. Nelson Emma M. Behnken Melissa S. Hart Lindsey R. Sangaralingham Shealeigh A. Inselman Michelle A. Lampman Shannon M. Dunlay Sean C. Dowdy Elizabeth B. Habermann |
| author_facet | Xiaoxi Yao Margaret Paulson Michael J. Maniaci Ajani N. Dunn Chad R. Nelson Emma M. Behnken Melissa S. Hart Lindsey R. Sangaralingham Shealeigh A. Inselman Michelle A. Lampman Shannon M. Dunlay Sean C. Dowdy Elizabeth B. Habermann |
| author_sort | Xiaoxi Yao |
| collection | DOAJ |
| description | Abstract Background Delivering acute hospital care to patients at home might reduce costs and improve patient experience. Mayo Clinic’s Advanced Care at Home (ACH) program is a novel virtual hybrid model of “Hospital at Home.” This pragmatic randomized controlled non-inferiority trial aims to compare two acute care delivery models: ACH vs. traditional brick-and-mortar hospital care in acutely ill patients. Methods We aim to enroll 360 acutely ill adult patients (≥18 years) who are admitted to three hospitals in Arizona, Florida, and Wisconsin, two of which are academic medical centers and one is a community-based practice. The eligibility criteria will follow what is used in routine practice determined by local clinical teams, including clinical stability, social stability, health insurance plans, and zip codes. Patients will be randomized 1:1 to ACH or traditional inpatient care, stratified by site. The primary outcome is a composite outcome of all-cause mortality and 30-day readmission. Secondary outcomes include individual outcomes in the composite endpoint, fall with injury, medication errors, emergency room visit, transfer to intensive care unit (ICU), cost, the number of days alive out of hospital, and patient-reported quality of life. A mixed-methods study will be conducted with patients, clinicians, and other staff to investigate their experience. Discussion The pragmatic trial will examine a novel virtual hybrid model for delivering high-acuity medical care at home. The findings will inform patient selection and future large-scale implementation. Trial registration ClinicalTrials.gov NCT05212077. Registered on 27 January 2022 |
| first_indexed | 2024-04-13T19:32:36Z |
| format | Article |
| id | doaj.art-afe614a1919f4eae82a2fbe721e5940e |
| institution | Directory Open Access Journal |
| issn | 1745-6215 |
| language | English |
| last_indexed | 2024-04-13T19:32:36Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Trials |
| spelling | doaj.art-afe614a1919f4eae82a2fbe721e5940e2022-12-22T02:33:08ZengBMCTrials1745-62152022-06-0123111210.1186/s13063-022-06430-6Effect of hospital-at-home vs. traditional brick-and-mortar hospital care in acutely ill adults: study protocol for a pragmatic randomized controlled trialXiaoxi Yao0Margaret Paulson1Michael J. Maniaci2Ajani N. Dunn3Chad R. Nelson4Emma M. Behnken5Melissa S. Hart6Lindsey R. Sangaralingham7Shealeigh A. Inselman8Michelle A. Lampman9Shannon M. Dunlay10Sean C. Dowdy11Elizabeth B. Habermann12Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo ClinicDivision of Hospital Internal Medicine, Mayo Clinic Health SystemsDivision of Hospital Internal Medicine, Mayo ClinicAdministrative Operations, Mayo ClinicDivision of Hospital Internal Medicine, Mayo ClinicKnowledge and Evaluation Research Unit, Mayo ClinicRobert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo ClinicRobert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo ClinicRobert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo ClinicRobert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo ClinicRobert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo ClinicRobert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo ClinicRobert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo ClinicAbstract Background Delivering acute hospital care to patients at home might reduce costs and improve patient experience. Mayo Clinic’s Advanced Care at Home (ACH) program is a novel virtual hybrid model of “Hospital at Home.” This pragmatic randomized controlled non-inferiority trial aims to compare two acute care delivery models: ACH vs. traditional brick-and-mortar hospital care in acutely ill patients. Methods We aim to enroll 360 acutely ill adult patients (≥18 years) who are admitted to three hospitals in Arizona, Florida, and Wisconsin, two of which are academic medical centers and one is a community-based practice. The eligibility criteria will follow what is used in routine practice determined by local clinical teams, including clinical stability, social stability, health insurance plans, and zip codes. Patients will be randomized 1:1 to ACH or traditional inpatient care, stratified by site. The primary outcome is a composite outcome of all-cause mortality and 30-day readmission. Secondary outcomes include individual outcomes in the composite endpoint, fall with injury, medication errors, emergency room visit, transfer to intensive care unit (ICU), cost, the number of days alive out of hospital, and patient-reported quality of life. A mixed-methods study will be conducted with patients, clinicians, and other staff to investigate their experience. Discussion The pragmatic trial will examine a novel virtual hybrid model for delivering high-acuity medical care at home. The findings will inform patient selection and future large-scale implementation. Trial registration ClinicalTrials.gov NCT05212077. Registered on 27 January 2022https://doi.org/10.1186/s13063-022-06430-6Advanced care at homeHospital at homeInpatientPragmatic trial |
| spellingShingle | Xiaoxi Yao Margaret Paulson Michael J. Maniaci Ajani N. Dunn Chad R. Nelson Emma M. Behnken Melissa S. Hart Lindsey R. Sangaralingham Shealeigh A. Inselman Michelle A. Lampman Shannon M. Dunlay Sean C. Dowdy Elizabeth B. Habermann Effect of hospital-at-home vs. traditional brick-and-mortar hospital care in acutely ill adults: study protocol for a pragmatic randomized controlled trial Trials Advanced care at home Hospital at home Inpatient Pragmatic trial |
| title | Effect of hospital-at-home vs. traditional brick-and-mortar hospital care in acutely ill adults: study protocol for a pragmatic randomized controlled trial |
| title_full | Effect of hospital-at-home vs. traditional brick-and-mortar hospital care in acutely ill adults: study protocol for a pragmatic randomized controlled trial |
| title_fullStr | Effect of hospital-at-home vs. traditional brick-and-mortar hospital care in acutely ill adults: study protocol for a pragmatic randomized controlled trial |
| title_full_unstemmed | Effect of hospital-at-home vs. traditional brick-and-mortar hospital care in acutely ill adults: study protocol for a pragmatic randomized controlled trial |
| title_short | Effect of hospital-at-home vs. traditional brick-and-mortar hospital care in acutely ill adults: study protocol for a pragmatic randomized controlled trial |
| title_sort | effect of hospital at home vs traditional brick and mortar hospital care in acutely ill adults study protocol for a pragmatic randomized controlled trial |
| topic | Advanced care at home Hospital at home Inpatient Pragmatic trial |
| url | https://doi.org/10.1186/s13063-022-06430-6 |
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