Aiming to Improve Readmissions Through InteGrated Hospital Transitions (AIRTIGHT): study protocol for a randomized controlled trial View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2016-12

AUTHORS

Andrew McWilliams, Jason Roberge, Charity G. Moore, Avery Ashby, Whitney Rossman, Stephanie Murphy, Stephannie McCall, Ryan Brown, Shannon Carpenter, Scott Rissmiller, Scott Furney

ABSTRACT

BACKGROUND: Hospital readmissions remain highly prevalent despite being the target of policies and financial penalties. Evidence comparing the effectiveness and costs of interventions to reduce readmissions is lacking, leaving healthcare systems with little guidance on how to improve quality and avoid costly penalties. Effective interventions likely need to bridge inpatient and outpatient settings, incorporate information technology, and use dedicated providers. Such complex innovations will require rigorous evaluation. The framework of quality improvement research provides an approach that both improves care locally and contributes to closing the current knowledge gaps for readmissions. In this trial, we will study a comprehensive intervention that incorporates these recommendations into an integrated practice unit, called transition services, with an aim of reducing 30-day readmission rates. METHODS/DESIGN: We describe a nonblinded, pragmatic, controlled trial with two parallel groups comprising an evaluation of the effect of referral to a provider-led integrated practice unit, inclusive of comprehensive multidisciplinary care, dedicated paramedicine providers, and virtual visits, on 30-day readmission rates for high-risk hospitalized patients. An automated risk-scoring system will randomly generate referrals to either transition services or usual care for 1520 hospitalized patients who score as high-risk for readmission. Transition services will then engage with patients in the hospital setting using a patient navigator and provide bridging outpatient services for the 30 days following discharge. All outcome data are retrieved electronically from administrative medical records. After reapplication of inclusion and exclusion criteria at the time of hospital discharge, analyses will follow the intention-to-treat principle such that patients will be analyzed on the basis of the referral group to which they were initially randomized. DISCUSSION: The hospital transition program under study is complex and integrates the latest recommendations for readmission reduction strategies. As healthcare systems innovate to address readmissions through such complex interventions, there is significant benefit for stakeholders to have a clear understanding of the potential reach, cost, and real-world effectiveness. The pragmatic methods described here provide a template for conducting quality improvement research that fits seamlessly into existing care delivery and improvement efforts, leading to better-informed strategic decisions and the investments necessary to transform care and value for patients. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02763202 . Registered 3 March 2016 (retrospectively registered). More... »

PAGES

603

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s13063-016-1725-2

DOI

http://dx.doi.org/10.1186/s13063-016-1725-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1040095190

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/27993163


Indexing Status Check whether this publication has been indexed by Scopus and Web Of Science using the SN Indexing Status Tool
Incoming Citations Browse incoming citations for this publication using opencitations.net

JSON-LD is the canonical representation for SciGraph data.

TIP: You can open this SciGraph record using an external JSON-LD service: JSON-LD Playground Google SDTT

[
  {
    "@context": "https://springernature.github.io/scigraph/jsonld/sgcontext.json", 
    "about": [
      {
        "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/1117", 
        "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
        "name": "Public Health and Health Services", 
        "type": "DefinedTerm"
      }, 
      {
        "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/11", 
        "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
        "name": "Medical and Health Sciences", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Delivery of Health Care, Integrated", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Humans", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "North Carolina", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Patient Care Team", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Patient Readmission", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Patient Transfer", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Program Evaluation", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Quality Improvement", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Quality Indicators, Health Care", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Research Design", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Risk Factors", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Time Factors", 
        "type": "DefinedTerm"
      }
    ], 
    "author": [
      {
        "affiliation": {
          "alternateName": "Carolinas Healthcare System", 
          "id": "https://www.grid.ac/institutes/grid.427669.8", 
          "name": [
            "Center for Outcomes Research and Evaluation, Carolinas HealthCare System, 1540 Garden Terrace, 28203, Charlotte, NC, USA", 
            "Carolinas Hospitalist Group, Carolinas HealthCare System, 801 East Boulevard, 28203, Charlotte, NC, USA"
          ], 
          "type": "Organization"
        }, 
        "familyName": "McWilliams", 
        "givenName": "Andrew", 
        "id": "sg:person.01031030246.66", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01031030246.66"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Carolinas Healthcare System", 
          "id": "https://www.grid.ac/institutes/grid.427669.8", 
          "name": [
            "Dickson Advanced Analytics, Carolinas HealthCare System, 720 East Morehead Street, Suite 202, 28202, Charlotte, NC, USA"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Roberge", 
        "givenName": "Jason", 
        "id": "sg:person.01077104355.03", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01077104355.03"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Carolinas Healthcare System", 
          "id": "https://www.grid.ac/institutes/grid.427669.8", 
          "name": [
            "Center for Outcomes Research and Evaluation, Carolinas HealthCare System, 1540 Garden Terrace, 28203, Charlotte, NC, USA"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Moore", 
        "givenName": "Charity G.", 
        "id": "sg:person.015773516347.81", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.015773516347.81"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Carolinas Healthcare System", 
          "id": "https://www.grid.ac/institutes/grid.427669.8", 
          "name": [
            "Dickson Advanced Analytics, Carolinas HealthCare System, 720 East Morehead Street, Suite 202, 28202, Charlotte, NC, USA"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Ashby", 
        "givenName": "Avery", 
        "id": "sg:person.0740115121.04", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0740115121.04"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Carolinas Healthcare System", 
          "id": "https://www.grid.ac/institutes/grid.427669.8", 
          "name": [
            "Center for Outcomes Research and Evaluation, Carolinas HealthCare System, 1540 Garden Terrace, 28203, Charlotte, NC, USA"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Rossman", 
        "givenName": "Whitney", 
        "id": "sg:person.01073713377.14", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01073713377.14"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Carolinas Healthcare System", 
          "id": "https://www.grid.ac/institutes/grid.427669.8", 
          "name": [
            "Carolinas Hospitalist Group, Carolinas HealthCare System, 801 East Boulevard, 28203, Charlotte, NC, USA"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Murphy", 
        "givenName": "Stephanie", 
        "id": "sg:person.013710147755.12", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.013710147755.12"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Carolinas Healthcare System", 
          "id": "https://www.grid.ac/institutes/grid.427669.8", 
          "name": [
            "Carolinas Hospitalist Group, Carolinas HealthCare System, 801 East Boulevard, 28203, Charlotte, NC, USA"
          ], 
          "type": "Organization"
        }, 
        "familyName": "McCall", 
        "givenName": "Stephannie", 
        "id": "sg:person.014505530355.49", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.014505530355.49"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Carolinas Healthcare System", 
          "id": "https://www.grid.ac/institutes/grid.427669.8", 
          "name": [
            "Carolinas Hospitalist Group, Carolinas HealthCare System, 801 East Boulevard, 28203, Charlotte, NC, USA"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Brown", 
        "givenName": "Ryan", 
        "id": "sg:person.015303110755.69", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.015303110755.69"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Carolinas Healthcare System", 
          "id": "https://www.grid.ac/institutes/grid.427669.8", 
          "name": [
            "Medical Group Acute Care Division, Carolinas HealthCare System, 1000 Blythe Boulevard, 28203, Charlotte, NC, USA"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Carpenter", 
        "givenName": "Shannon", 
        "id": "sg:person.016100471355.46", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.016100471355.46"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Carolinas Healthcare System", 
          "id": "https://www.grid.ac/institutes/grid.427669.8", 
          "name": [
            "Medical Group Acute Care Division, Carolinas HealthCare System, 1000 Blythe Boulevard, 28203, Charlotte, NC, USA"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Rissmiller", 
        "givenName": "Scott", 
        "id": "sg:person.016676051755.38", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.016676051755.38"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Carolinas Healthcare System", 
          "id": "https://www.grid.ac/institutes/grid.427669.8", 
          "name": [
            "Department Internal Medicine, Carolinas HealthCare System, 1000 Blythe Boulevard, 28203, Charlotte, NC, USA"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Furney", 
        "givenName": "Scott", 
        "id": "sg:person.07401261255.17", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.07401261255.17"
        ], 
        "type": "Person"
      }
    ], 
    "citation": [
      {
        "id": "https://doi.org/10.1056/nejmsa1513024", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1005867518"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1503/cmaj.090523", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1007763679"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1503/cmaj.090523", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1007763679"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/s12910-015-0056-2", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1020756845", 
          "https://doi.org/10.1186/s12910-015-0056-2"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1146/annurev-med-022613-090415", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1023309469"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1001/jamainternmed.2013.13297", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1024033922"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1001/archinte.166.17.1822", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1024669355"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1002/jhm.2502", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1025629920"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1007/s11606-010-1291-3", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1026147381", 
          "https://doi.org/10.1007/s11606-010-1291-3"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1007/s11606-010-1291-3", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1026147381", 
          "https://doi.org/10.1007/s11606-010-1291-3"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1177/1740774515597682", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1031699841"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1177/1740774515597682", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1031699841"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1001/jamainternmed.2014.1608", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1032617238"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1136/bmj.h2147", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1033039808"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1377/hlthaff.27.3.759", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1035126211"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://app.dimensions.ai/details/publication/pub.1038653125", 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1007/978-1-4419-1586-3", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1038653125", 
          "https://doi.org/10.1007/978-1-4419-1586-3"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1007/978-1-4419-1586-3", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1038653125", 
          "https://doi.org/10.1007/978-1-4419-1586-3"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1001/jama.2014.11492", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1041831890"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.2105/ajph.89.9.1322", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1068877261"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.5694/mja12.10480", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1073072621"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.5694/mja12.10480", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1073072621"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.7326/0003-4819-150-3-200902030-00007", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1073710571"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.7326/0003-4819-155-8-201110180-00008", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1073712513"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.7326/0003-4819-158-3-201302050-00583", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1073713447"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.7326/0003-4819-158-5-201303051-00011", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1073713511"
        ], 
        "type": "CreativeWork"
      }
    ], 
    "datePublished": "2016-12", 
    "datePublishedReg": "2016-12-01", 
    "description": "BACKGROUND: Hospital readmissions remain highly prevalent despite being the target of policies and financial penalties. Evidence comparing the effectiveness and costs of interventions to reduce readmissions is lacking, leaving healthcare systems with little guidance on how to improve quality and avoid costly penalties. Effective interventions likely need to bridge inpatient and outpatient settings, incorporate information technology, and use dedicated providers. Such complex innovations will require rigorous evaluation. The framework of quality improvement research provides an approach that both improves care locally and contributes to closing the current knowledge gaps for readmissions. In this trial, we will study a comprehensive intervention that incorporates these recommendations into an integrated practice unit, called transition services, with an aim of reducing 30-day readmission rates.\nMETHODS/DESIGN: We describe a nonblinded, pragmatic, controlled trial with two parallel groups comprising an evaluation of the effect of referral to a provider-led integrated practice unit, inclusive of comprehensive multidisciplinary care, dedicated paramedicine providers, and virtual visits, on 30-day readmission rates for high-risk hospitalized patients. An automated risk-scoring system will randomly generate referrals to either transition services or usual care for 1520 hospitalized patients who score as high-risk for readmission. Transition services will then engage with patients in the hospital setting using a patient navigator and provide bridging outpatient services for the 30\u00a0days following discharge. All outcome data are retrieved electronically from administrative medical records. After reapplication of inclusion and exclusion criteria at the time of hospital discharge, analyses will follow the intention-to-treat principle such that patients will be analyzed on the basis of the referral group to which they were initially randomized.\nDISCUSSION: The hospital transition program under study is complex and integrates the latest recommendations for readmission reduction strategies. As healthcare systems innovate to address readmissions through such complex interventions, there is significant benefit for stakeholders to have a clear understanding of the potential reach, cost, and real-world effectiveness. The pragmatic methods described here provide a template for conducting quality improvement research that fits seamlessly into existing care delivery and improvement efforts, leading to better-informed strategic decisions and the investments necessary to transform care and value for patients.\nTRIAL REGISTRATION: ClinicalTrials.gov, NCT02763202 . Registered 3 March 2016 (retrospectively registered).", 
    "genre": "research_article", 
    "id": "sg:pub.10.1186/s13063-016-1725-2", 
    "inLanguage": [
      "en"
    ], 
    "isAccessibleForFree": true, 
    "isPartOf": [
      {
        "id": "sg:journal.1297400", 
        "issn": [
          "1468-6708", 
          "1745-6215"
        ], 
        "name": "Trials", 
        "type": "Periodical"
      }, 
      {
        "issueNumber": "1", 
        "type": "PublicationIssue"
      }, 
      {
        "type": "PublicationVolume", 
        "volumeNumber": "17"
      }
    ], 
    "name": "Aiming to Improve Readmissions Through InteGrated Hospital Transitions (AIRTIGHT): study protocol for a randomized controlled trial", 
    "pagination": "603", 
    "productId": [
      {
        "name": "readcube_id", 
        "type": "PropertyValue", 
        "value": [
          "beffbae76a1f0be88ddc71922b179b9d8175d0f71b95a7d2cb390d5d77d03f33"
        ]
      }, 
      {
        "name": "pubmed_id", 
        "type": "PropertyValue", 
        "value": [
          "27993163"
        ]
      }, 
      {
        "name": "nlm_unique_id", 
        "type": "PropertyValue", 
        "value": [
          "101263253"
        ]
      }, 
      {
        "name": "doi", 
        "type": "PropertyValue", 
        "value": [
          "10.1186/s13063-016-1725-2"
        ]
      }, 
      {
        "name": "dimensions_id", 
        "type": "PropertyValue", 
        "value": [
          "pub.1040095190"
        ]
      }
    ], 
    "sameAs": [
      "https://doi.org/10.1186/s13063-016-1725-2", 
      "https://app.dimensions.ai/details/publication/pub.1040095190"
    ], 
    "sdDataset": "articles", 
    "sdDatePublished": "2019-04-11T10:35", 
    "sdLicense": "https://scigraph.springernature.com/explorer/license/", 
    "sdPublisher": {
      "name": "Springer Nature - SN SciGraph project", 
      "type": "Organization"
    }, 
    "sdSource": "s3://com-uberresearch-data-dimensions-target-20181106-alternative/cleanup/v134/2549eaecd7973599484d7c17b260dba0a4ecb94b/merge/v9/a6c9fde33151104705d4d7ff012ea9563521a3ce/jats-lookup/v90/0000000349_0000000349/records_113667_00000001.jsonl", 
    "type": "ScholarlyArticle", 
    "url": "https://link.springer.com/10.1186%2Fs13063-016-1725-2"
  }
]
 

Download the RDF metadata as:  json-ld nt turtle xml License info

HOW TO GET THIS DATA PROGRAMMATICALLY:

JSON-LD is a popular format for linked data which is fully compatible with JSON.

curl -H 'Accept: application/ld+json' 'https://scigraph.springernature.com/pub.10.1186/s13063-016-1725-2'

N-Triples is a line-based linked data format ideal for batch operations.

curl -H 'Accept: application/n-triples' 'https://scigraph.springernature.com/pub.10.1186/s13063-016-1725-2'

Turtle is a human-readable linked data format.

curl -H 'Accept: text/turtle' 'https://scigraph.springernature.com/pub.10.1186/s13063-016-1725-2'

RDF/XML is a standard XML format for linked data.

curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/pub.10.1186/s13063-016-1725-2'


 

This table displays all metadata directly associated to this object as RDF triples.

256 TRIPLES      21 PREDICATES      62 URIs      33 LITERALS      21 BLANK NODES

Subject Predicate Object
1 sg:pub.10.1186/s13063-016-1725-2 schema:about N045148035a84478e8fe799da4f0a7e05
2 N103173f3032f4af9bfdbcbd141757cf2
3 N595abb307b5a457783619fa4f300ce53
4 N5d73cc973c7d4513be95633c0c586b8b
5 N72f7f65eadac42e1bbf22d43b5eedfbe
6 N83838e06b08548979801f6710eac4671
7 N8aaf8b8275aa465b81691b68fe130b2f
8 Na5df25e150b24df8b16ebbd8f0eb3d45
9 Nb923790f7f5b4cb7ae81bb05f0645464
10 Nbf3c29641fe8441a837ea0c3bfd60f44
11 Nceca31e6353344aaa990e6efd2916160
12 Nec2b428bde6c471dbdaaff9459e29fd7
13 anzsrc-for:11
14 anzsrc-for:1117
15 schema:author Nac899db1a4e74b9a85c6786b0d1c5865
16 schema:citation sg:pub.10.1007/978-1-4419-1586-3
17 sg:pub.10.1007/s11606-010-1291-3
18 sg:pub.10.1186/s12910-015-0056-2
19 https://app.dimensions.ai/details/publication/pub.1038653125
20 https://doi.org/10.1001/archinte.166.17.1822
21 https://doi.org/10.1001/jama.2014.11492
22 https://doi.org/10.1001/jamainternmed.2013.13297
23 https://doi.org/10.1001/jamainternmed.2014.1608
24 https://doi.org/10.1002/jhm.2502
25 https://doi.org/10.1056/nejmsa1513024
26 https://doi.org/10.1136/bmj.h2147
27 https://doi.org/10.1146/annurev-med-022613-090415
28 https://doi.org/10.1177/1740774515597682
29 https://doi.org/10.1377/hlthaff.27.3.759
30 https://doi.org/10.1503/cmaj.090523
31 https://doi.org/10.2105/ajph.89.9.1322
32 https://doi.org/10.5694/mja12.10480
33 https://doi.org/10.7326/0003-4819-150-3-200902030-00007
34 https://doi.org/10.7326/0003-4819-155-8-201110180-00008
35 https://doi.org/10.7326/0003-4819-158-3-201302050-00583
36 https://doi.org/10.7326/0003-4819-158-5-201303051-00011
37 schema:datePublished 2016-12
38 schema:datePublishedReg 2016-12-01
39 schema:description BACKGROUND: Hospital readmissions remain highly prevalent despite being the target of policies and financial penalties. Evidence comparing the effectiveness and costs of interventions to reduce readmissions is lacking, leaving healthcare systems with little guidance on how to improve quality and avoid costly penalties. Effective interventions likely need to bridge inpatient and outpatient settings, incorporate information technology, and use dedicated providers. Such complex innovations will require rigorous evaluation. The framework of quality improvement research provides an approach that both improves care locally and contributes to closing the current knowledge gaps for readmissions. In this trial, we will study a comprehensive intervention that incorporates these recommendations into an integrated practice unit, called transition services, with an aim of reducing 30-day readmission rates. METHODS/DESIGN: We describe a nonblinded, pragmatic, controlled trial with two parallel groups comprising an evaluation of the effect of referral to a provider-led integrated practice unit, inclusive of comprehensive multidisciplinary care, dedicated paramedicine providers, and virtual visits, on 30-day readmission rates for high-risk hospitalized patients. An automated risk-scoring system will randomly generate referrals to either transition services or usual care for 1520 hospitalized patients who score as high-risk for readmission. Transition services will then engage with patients in the hospital setting using a patient navigator and provide bridging outpatient services for the 30 days following discharge. All outcome data are retrieved electronically from administrative medical records. After reapplication of inclusion and exclusion criteria at the time of hospital discharge, analyses will follow the intention-to-treat principle such that patients will be analyzed on the basis of the referral group to which they were initially randomized. DISCUSSION: The hospital transition program under study is complex and integrates the latest recommendations for readmission reduction strategies. As healthcare systems innovate to address readmissions through such complex interventions, there is significant benefit for stakeholders to have a clear understanding of the potential reach, cost, and real-world effectiveness. The pragmatic methods described here provide a template for conducting quality improvement research that fits seamlessly into existing care delivery and improvement efforts, leading to better-informed strategic decisions and the investments necessary to transform care and value for patients. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02763202 . Registered 3 March 2016 (retrospectively registered).
40 schema:genre research_article
41 schema:inLanguage en
42 schema:isAccessibleForFree true
43 schema:isPartOf N37f7e9623ae247a78a09c6f8156cc72f
44 N9e7193dad33e41ddb7bc55a628e44031
45 sg:journal.1297400
46 schema:name Aiming to Improve Readmissions Through InteGrated Hospital Transitions (AIRTIGHT): study protocol for a randomized controlled trial
47 schema:pagination 603
48 schema:productId N36c9420ac51c458c9c8c7d7db02a7739
49 N5ba07f8a1acc422ea32fe5ace4136afe
50 N7247070f74cc456cad7efb11b260b9cd
51 N78cc21dcd20c46f3a798a9058cea40e5
52 Nd02d273986ef4670856ba8802aaebc5c
53 schema:sameAs https://app.dimensions.ai/details/publication/pub.1040095190
54 https://doi.org/10.1186/s13063-016-1725-2
55 schema:sdDatePublished 2019-04-11T10:35
56 schema:sdLicense https://scigraph.springernature.com/explorer/license/
57 schema:sdPublisher Ne635ecbe04124cdabeebdcd30f00fb65
58 schema:url https://link.springer.com/10.1186%2Fs13063-016-1725-2
59 sgo:license sg:explorer/license/
60 sgo:sdDataset articles
61 rdf:type schema:ScholarlyArticle
62 N033ad860a2f44fe6bba51560d7bb72e2 rdf:first sg:person.0740115121.04
63 rdf:rest Nbb28d6db5cf84602a911d8f86de9f97f
64 N045148035a84478e8fe799da4f0a7e05 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
65 schema:name North Carolina
66 rdf:type schema:DefinedTerm
67 N045e8204ed6e4471875a49fc5a68ef92 rdf:first sg:person.01077104355.03
68 rdf:rest N2dabc48a4c66468dac3e6d64419dcad4
69 N103173f3032f4af9bfdbcbd141757cf2 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
70 schema:name Patient Care Team
71 rdf:type schema:DefinedTerm
72 N2dabc48a4c66468dac3e6d64419dcad4 rdf:first sg:person.015773516347.81
73 rdf:rest N033ad860a2f44fe6bba51560d7bb72e2
74 N36c9420ac51c458c9c8c7d7db02a7739 schema:name readcube_id
75 schema:value beffbae76a1f0be88ddc71922b179b9d8175d0f71b95a7d2cb390d5d77d03f33
76 rdf:type schema:PropertyValue
77 N37f7e9623ae247a78a09c6f8156cc72f schema:volumeNumber 17
78 rdf:type schema:PublicationVolume
79 N595abb307b5a457783619fa4f300ce53 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
80 schema:name Quality Indicators, Health Care
81 rdf:type schema:DefinedTerm
82 N5ba07f8a1acc422ea32fe5ace4136afe schema:name nlm_unique_id
83 schema:value 101263253
84 rdf:type schema:PropertyValue
85 N5d73cc973c7d4513be95633c0c586b8b schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
86 schema:name Delivery of Health Care, Integrated
87 rdf:type schema:DefinedTerm
88 N7247070f74cc456cad7efb11b260b9cd schema:name pubmed_id
89 schema:value 27993163
90 rdf:type schema:PropertyValue
91 N72f7f65eadac42e1bbf22d43b5eedfbe schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
92 schema:name Time Factors
93 rdf:type schema:DefinedTerm
94 N78cc21dcd20c46f3a798a9058cea40e5 schema:name doi
95 schema:value 10.1186/s13063-016-1725-2
96 rdf:type schema:PropertyValue
97 N7d998fbfe1a0431283e0eae80d9d1c6c rdf:first sg:person.013710147755.12
98 rdf:rest Nbd5a02ec86744bb5a900aff7d3e099a6
99 N83838e06b08548979801f6710eac4671 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
100 schema:name Risk Factors
101 rdf:type schema:DefinedTerm
102 N8aaf8b8275aa465b81691b68fe130b2f schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
103 schema:name Humans
104 rdf:type schema:DefinedTerm
105 N9e7193dad33e41ddb7bc55a628e44031 schema:issueNumber 1
106 rdf:type schema:PublicationIssue
107 Na4e2977768d44a4b9b5238a7f7914d85 rdf:first sg:person.015303110755.69
108 rdf:rest Nb7421e5150274d938afb23dde97c42e6
109 Na5df25e150b24df8b16ebbd8f0eb3d45 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
110 schema:name Patient Readmission
111 rdf:type schema:DefinedTerm
112 Nac899db1a4e74b9a85c6786b0d1c5865 rdf:first sg:person.01031030246.66
113 rdf:rest N045e8204ed6e4471875a49fc5a68ef92
114 Nad28a41a81c54b84b73f126e47715052 rdf:first sg:person.07401261255.17
115 rdf:rest rdf:nil
116 Nb7421e5150274d938afb23dde97c42e6 rdf:first sg:person.016100471355.46
117 rdf:rest Nd356bb435d0648ad82b7e17cd1f212ff
118 Nb923790f7f5b4cb7ae81bb05f0645464 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
119 schema:name Quality Improvement
120 rdf:type schema:DefinedTerm
121 Nbb28d6db5cf84602a911d8f86de9f97f rdf:first sg:person.01073713377.14
122 rdf:rest N7d998fbfe1a0431283e0eae80d9d1c6c
123 Nbd5a02ec86744bb5a900aff7d3e099a6 rdf:first sg:person.014505530355.49
124 rdf:rest Na4e2977768d44a4b9b5238a7f7914d85
125 Nbf3c29641fe8441a837ea0c3bfd60f44 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
126 schema:name Research Design
127 rdf:type schema:DefinedTerm
128 Nceca31e6353344aaa990e6efd2916160 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
129 schema:name Program Evaluation
130 rdf:type schema:DefinedTerm
131 Nd02d273986ef4670856ba8802aaebc5c schema:name dimensions_id
132 schema:value pub.1040095190
133 rdf:type schema:PropertyValue
134 Nd356bb435d0648ad82b7e17cd1f212ff rdf:first sg:person.016676051755.38
135 rdf:rest Nad28a41a81c54b84b73f126e47715052
136 Ne635ecbe04124cdabeebdcd30f00fb65 schema:name Springer Nature - SN SciGraph project
137 rdf:type schema:Organization
138 Nec2b428bde6c471dbdaaff9459e29fd7 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
139 schema:name Patient Transfer
140 rdf:type schema:DefinedTerm
141 anzsrc-for:11 schema:inDefinedTermSet anzsrc-for:
142 schema:name Medical and Health Sciences
143 rdf:type schema:DefinedTerm
144 anzsrc-for:1117 schema:inDefinedTermSet anzsrc-for:
145 schema:name Public Health and Health Services
146 rdf:type schema:DefinedTerm
147 sg:journal.1297400 schema:issn 1468-6708
148 1745-6215
149 schema:name Trials
150 rdf:type schema:Periodical
151 sg:person.01031030246.66 schema:affiliation https://www.grid.ac/institutes/grid.427669.8
152 schema:familyName McWilliams
153 schema:givenName Andrew
154 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01031030246.66
155 rdf:type schema:Person
156 sg:person.01073713377.14 schema:affiliation https://www.grid.ac/institutes/grid.427669.8
157 schema:familyName Rossman
158 schema:givenName Whitney
159 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01073713377.14
160 rdf:type schema:Person
161 sg:person.01077104355.03 schema:affiliation https://www.grid.ac/institutes/grid.427669.8
162 schema:familyName Roberge
163 schema:givenName Jason
164 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01077104355.03
165 rdf:type schema:Person
166 sg:person.013710147755.12 schema:affiliation https://www.grid.ac/institutes/grid.427669.8
167 schema:familyName Murphy
168 schema:givenName Stephanie
169 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.013710147755.12
170 rdf:type schema:Person
171 sg:person.014505530355.49 schema:affiliation https://www.grid.ac/institutes/grid.427669.8
172 schema:familyName McCall
173 schema:givenName Stephannie
174 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.014505530355.49
175 rdf:type schema:Person
176 sg:person.015303110755.69 schema:affiliation https://www.grid.ac/institutes/grid.427669.8
177 schema:familyName Brown
178 schema:givenName Ryan
179 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.015303110755.69
180 rdf:type schema:Person
181 sg:person.015773516347.81 schema:affiliation https://www.grid.ac/institutes/grid.427669.8
182 schema:familyName Moore
183 schema:givenName Charity G.
184 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.015773516347.81
185 rdf:type schema:Person
186 sg:person.016100471355.46 schema:affiliation https://www.grid.ac/institutes/grid.427669.8
187 schema:familyName Carpenter
188 schema:givenName Shannon
189 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.016100471355.46
190 rdf:type schema:Person
191 sg:person.016676051755.38 schema:affiliation https://www.grid.ac/institutes/grid.427669.8
192 schema:familyName Rissmiller
193 schema:givenName Scott
194 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.016676051755.38
195 rdf:type schema:Person
196 sg:person.0740115121.04 schema:affiliation https://www.grid.ac/institutes/grid.427669.8
197 schema:familyName Ashby
198 schema:givenName Avery
199 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0740115121.04
200 rdf:type schema:Person
201 sg:person.07401261255.17 schema:affiliation https://www.grid.ac/institutes/grid.427669.8
202 schema:familyName Furney
203 schema:givenName Scott
204 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.07401261255.17
205 rdf:type schema:Person
206 sg:pub.10.1007/978-1-4419-1586-3 schema:sameAs https://app.dimensions.ai/details/publication/pub.1038653125
207 https://doi.org/10.1007/978-1-4419-1586-3
208 rdf:type schema:CreativeWork
209 sg:pub.10.1007/s11606-010-1291-3 schema:sameAs https://app.dimensions.ai/details/publication/pub.1026147381
210 https://doi.org/10.1007/s11606-010-1291-3
211 rdf:type schema:CreativeWork
212 sg:pub.10.1186/s12910-015-0056-2 schema:sameAs https://app.dimensions.ai/details/publication/pub.1020756845
213 https://doi.org/10.1186/s12910-015-0056-2
214 rdf:type schema:CreativeWork
215 https://app.dimensions.ai/details/publication/pub.1038653125 schema:CreativeWork
216 https://doi.org/10.1001/archinte.166.17.1822 schema:sameAs https://app.dimensions.ai/details/publication/pub.1024669355
217 rdf:type schema:CreativeWork
218 https://doi.org/10.1001/jama.2014.11492 schema:sameAs https://app.dimensions.ai/details/publication/pub.1041831890
219 rdf:type schema:CreativeWork
220 https://doi.org/10.1001/jamainternmed.2013.13297 schema:sameAs https://app.dimensions.ai/details/publication/pub.1024033922
221 rdf:type schema:CreativeWork
222 https://doi.org/10.1001/jamainternmed.2014.1608 schema:sameAs https://app.dimensions.ai/details/publication/pub.1032617238
223 rdf:type schema:CreativeWork
224 https://doi.org/10.1002/jhm.2502 schema:sameAs https://app.dimensions.ai/details/publication/pub.1025629920
225 rdf:type schema:CreativeWork
226 https://doi.org/10.1056/nejmsa1513024 schema:sameAs https://app.dimensions.ai/details/publication/pub.1005867518
227 rdf:type schema:CreativeWork
228 https://doi.org/10.1136/bmj.h2147 schema:sameAs https://app.dimensions.ai/details/publication/pub.1033039808
229 rdf:type schema:CreativeWork
230 https://doi.org/10.1146/annurev-med-022613-090415 schema:sameAs https://app.dimensions.ai/details/publication/pub.1023309469
231 rdf:type schema:CreativeWork
232 https://doi.org/10.1177/1740774515597682 schema:sameAs https://app.dimensions.ai/details/publication/pub.1031699841
233 rdf:type schema:CreativeWork
234 https://doi.org/10.1377/hlthaff.27.3.759 schema:sameAs https://app.dimensions.ai/details/publication/pub.1035126211
235 rdf:type schema:CreativeWork
236 https://doi.org/10.1503/cmaj.090523 schema:sameAs https://app.dimensions.ai/details/publication/pub.1007763679
237 rdf:type schema:CreativeWork
238 https://doi.org/10.2105/ajph.89.9.1322 schema:sameAs https://app.dimensions.ai/details/publication/pub.1068877261
239 rdf:type schema:CreativeWork
240 https://doi.org/10.5694/mja12.10480 schema:sameAs https://app.dimensions.ai/details/publication/pub.1073072621
241 rdf:type schema:CreativeWork
242 https://doi.org/10.7326/0003-4819-150-3-200902030-00007 schema:sameAs https://app.dimensions.ai/details/publication/pub.1073710571
243 rdf:type schema:CreativeWork
244 https://doi.org/10.7326/0003-4819-155-8-201110180-00008 schema:sameAs https://app.dimensions.ai/details/publication/pub.1073712513
245 rdf:type schema:CreativeWork
246 https://doi.org/10.7326/0003-4819-158-3-201302050-00583 schema:sameAs https://app.dimensions.ai/details/publication/pub.1073713447
247 rdf:type schema:CreativeWork
248 https://doi.org/10.7326/0003-4819-158-5-201303051-00011 schema:sameAs https://app.dimensions.ai/details/publication/pub.1073713511
249 rdf:type schema:CreativeWork
250 https://www.grid.ac/institutes/grid.427669.8 schema:alternateName Carolinas Healthcare System
251 schema:name Carolinas Hospitalist Group, Carolinas HealthCare System, 801 East Boulevard, 28203, Charlotte, NC, USA
252 Center for Outcomes Research and Evaluation, Carolinas HealthCare System, 1540 Garden Terrace, 28203, Charlotte, NC, USA
253 Department Internal Medicine, Carolinas HealthCare System, 1000 Blythe Boulevard, 28203, Charlotte, NC, USA
254 Dickson Advanced Analytics, Carolinas HealthCare System, 720 East Morehead Street, Suite 202, 28202, Charlotte, NC, USA
255 Medical Group Acute Care Division, Carolinas HealthCare System, 1000 Blythe Boulevard, 28203, Charlotte, NC, USA
256 rdf:type schema:Organization
 




Preview window. Press ESC to close (or click here)


...