HEARt Sounds: Audio Recordings to Improve Discharge Communication for Cardiology Inpatients
| Status: | Recruiting |
|---|---|
| Conditions: | Peripheral Vascular Disease |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 3/23/2019 |
| Start Date: | November 12, 2018 |
| End Date: | April 15, 2019 |
| Contact: | Michelle D Dannenberg, MPH |
| Email: | Michelle.D.Dannenberg@dartmouth.edu |
| Phone: | 603-653-0866 |
HEARt Sounds: A Pilot Randomized Trial to Determine the Feasibility and Acceptability of Audio Recordings to Improve Discharge Communication for Cardiology Inpatients
Ineffective hospital discharge communication can significantly impact patient understanding,
safety, and treatment adherence. This is especially true for cardiology patients, who leave
the hospital with complex discharge plans, a multitude of high-risk medications,
post-procedural care instructions and recommendations for drastic lifestyle changes, all
delivered in a time-pressured discharge discussion. The goal of this pilot trial is to
determine if it is possible to use audio recordings to supplement usual discharge
communication to improve cardiology patients' ability to understand and self-manage care
after leaving the hospital.
safety, and treatment adherence. This is especially true for cardiology patients, who leave
the hospital with complex discharge plans, a multitude of high-risk medications,
post-procedural care instructions and recommendations for drastic lifestyle changes, all
delivered in a time-pressured discharge discussion. The goal of this pilot trial is to
determine if it is possible to use audio recordings to supplement usual discharge
communication to improve cardiology patients' ability to understand and self-manage care
after leaving the hospital.
The study objective is to assess the feasibility and acceptability of providing audio
recorded discharge instructions to patients discharged from an inpatient cardiology service
using a two-arm randomized controlled design. Specifically, this pilot study aims to: 1)
Determine whether providing audio recorded discharge instructions as a supplemental discharge
communication tool is feasible for cardiology providers and patients to use during the
inpatient discharge discussion, 2) Determine whether it is acceptable for patients and
families to use audio recorded discharge instructions after hospital discharge to self-manage
care, and 3) Explore the impact of audio recording on patients' understanding of discharge
instructions, ability to self-manage care and ability to adhere to prescribed medications.
On the day of discharge, enrolled patients will be randomized to a usual care arm, which
includes bedside discussion and review of written discharge instructions with the discharging
provider, or to an intervention arm, which includes bedside discussion and review of written
discharge instructions with the discharging provider and an audio recording of that bedside
discharge discussion using block randomization at the provider level. All participants
randomized to the intervention arm will receive a portable, electronic recording device with
audio playback that contains a recording of the bedside discharge discussion, and will also
have the option to record the discharge discussion on a smartphone or receive access to the
recording online, via the Open Recording Automated Logging System (ORALS). The hypothesis is
providing audio recordings of discharge instructions will be feasible and acceptable to
cardiology patients and providers.
One week after discharge, all enrolled patients (both arms) will be contacted via telephone
to complete an interview about the use of written discharge instructions and a survey about
understanding of discharge instructions, confidence and ability to self-manage care, and
medication adherence. In addition, patients in the intervention arm will be interviewed about
how the audio recording of the discharge discussion was used.
recorded discharge instructions to patients discharged from an inpatient cardiology service
using a two-arm randomized controlled design. Specifically, this pilot study aims to: 1)
Determine whether providing audio recorded discharge instructions as a supplemental discharge
communication tool is feasible for cardiology providers and patients to use during the
inpatient discharge discussion, 2) Determine whether it is acceptable for patients and
families to use audio recorded discharge instructions after hospital discharge to self-manage
care, and 3) Explore the impact of audio recording on patients' understanding of discharge
instructions, ability to self-manage care and ability to adhere to prescribed medications.
On the day of discharge, enrolled patients will be randomized to a usual care arm, which
includes bedside discussion and review of written discharge instructions with the discharging
provider, or to an intervention arm, which includes bedside discussion and review of written
discharge instructions with the discharging provider and an audio recording of that bedside
discharge discussion using block randomization at the provider level. All participants
randomized to the intervention arm will receive a portable, electronic recording device with
audio playback that contains a recording of the bedside discharge discussion, and will also
have the option to record the discharge discussion on a smartphone or receive access to the
recording online, via the Open Recording Automated Logging System (ORALS). The hypothesis is
providing audio recordings of discharge instructions will be feasible and acceptable to
cardiology patients and providers.
One week after discharge, all enrolled patients (both arms) will be contacted via telephone
to complete an interview about the use of written discharge instructions and a survey about
understanding of discharge instructions, confidence and ability to self-manage care, and
medication adherence. In addition, patients in the intervention arm will be interviewed about
how the audio recording of the discharge discussion was used.
Inclusion Criteria:
- 18 years of age or older
- Cardiology inpatients
- Comfortable reading and writing in English
- Willing to have discharge conversation recorded
Exclusion Criteria:
- Patients who are unable or unwilling to provide written informed consent
- Diagnosis of dementia, schizophrenia and other psychotic disorders
- Have a substance-abuse disorder
- Severe uncorrected vision or hearing problems
- Currently living in skilled nursing facility or hospice
- Planned discharge to a structured facility (e.g., skilled nursing facility,
intermediate care facility, hospice)
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