Advanced Heart Care at Home
| Status: | Recruiting |
|---|---|
| Conditions: | Cardiology |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 3/10/2019 |
| Start Date: | November 13, 2018 |
| End Date: | March 1, 2020 |
| Contact: | Esther S Pak, MD |
| Email: | esther.pak@uphs.upenn.edu |
| Phone: | 2673246074 |
Advanced Heart Care at Home (AHCAH); a Pragmatic Randomized Trial for Clinicians Nudged to AHCAH, a Heart Failure Specific Home Palliative Care Services
End-of-life (EOL) care for heart failure (HF) patients includes high healthcare utilization
and costs, in part due to the lack of integration of optimal HF management and home-based
palliative care. In a pilot quality improvement project of clinician "nudges" to enroll
seriously ill HF patients in a home-based, integrated HF and palliative care platform, the
investigators demonstrated decreased healthcare utilization and costs and increased hospice
utilization among seriously ill HF patients. The investigators propose a pragmatic randomized
trial for clinicians of seriously ill HF patients admitted to three University of
Pennsylvania Health System Hospitals, randomly assigning an opt-in approach (usual care)
versus a "nudge" or opt-out approach of a visit from an Advanced Heart Care at Home (AHCAH)
liaison to clinicians of eligible patients to discuss and enroll in the AHCAH program, to
rigorously and scientifically evaluate clinical, utilization, and cost outcomes among
high-risk HF patients at the EOL, and to promote physician uptake of best practices.
and costs, in part due to the lack of integration of optimal HF management and home-based
palliative care. In a pilot quality improvement project of clinician "nudges" to enroll
seriously ill HF patients in a home-based, integrated HF and palliative care platform, the
investigators demonstrated decreased healthcare utilization and costs and increased hospice
utilization among seriously ill HF patients. The investigators propose a pragmatic randomized
trial for clinicians of seriously ill HF patients admitted to three University of
Pennsylvania Health System Hospitals, randomly assigning an opt-in approach (usual care)
versus a "nudge" or opt-out approach of a visit from an Advanced Heart Care at Home (AHCAH)
liaison to clinicians of eligible patients to discuss and enroll in the AHCAH program, to
rigorously and scientifically evaluate clinical, utilization, and cost outcomes among
high-risk HF patients at the EOL, and to promote physician uptake of best practices.
Inclusion Criteria:
1. At least 18 years of age
2. Reside within Caring Way's geographic catchment
3. Heart Failure ICD code from any previous healthcare encounter (inpatient or
outpatient) in the 12 months prior to index hospitalization
4. Admitted to a cardiology or hospitalist service
5. Palliative Connect score greater than 0.3
6. Index hospitalization during study period
Exclusion Criteria:
1. Less than 18 years of age
2. Pregnant women
3. Incarcerated patients
4. Homeless patients
5. Reside outside of Caring Way's geographic catchment
6. Patients without an identifiable primary physician for AHCAH staff to communicate with
as determined by the AHCAH liaison via EPIC
7. Prior hospitalization during study period
We found this trial at
1
site
Click here to add this to my saved trials
