Overview

This trial is active, not recruiting.

Condition frail older adutls
Treatment safe care model of care
Sponsor Cedars-Sinai Medical Center
Collaborator UniHealth Foundation
Start date July 2016
End date July 2018
Trial size 330 participants
Trial identifier NCT02854826, 44067

Summary

Systems Addressing Frail Elders (SAFE) Care is a nurse-led interprofessional team model to rapidly identify and provide safe and effective inpatient care to high risk older adults and help support their successful transition back to the community. Developed and demonstrated to be effective in one hospital - the model is now being disseminated and studied in three additional hospitals (multiple organizational case study).

United States No locations recruiting
Other Countries No locations recruiting

Study Design

Time perspective prospective
Arm
Site 1 (UCLA Regan Medical Center): Leaders from nursing, pharmacy, social work/case management, physician, administration, performance improvement, information systems and the Nursing Research/EBP Council will implement, monitor and evaluate the SAFE Care model of care. Two nursing units will be identified for staff training in screening at-risk older adults. One units will be randomly selected to initiate the SAFE Care program. The "comparison" unit staff will screen for at-risk patients and continue usual high standard of care assessments and care planning. Both units will be closely followed with formative and summative evaluation data presented for local and all-site findings.
safe care model of care
SAFE Care Model Site Intervention: Endorse best practices for frail patients; Identify frail patients promptly using multi-dimensional screening and assessments; Employ interprofessional unit-based care team approach to frailty risk reduction during inpatient stay and create post-acute care transitions (PACT) plan recommendations; Develop electronic health record templates for patient-centered interprofessional frailty notes; Communicate PACT plans to primary care providers to promote safe transitions to the ambulatory setting and across the continuum of care. Increase awareness, improve management of frailty, and improve overall health and well-being for adults who are frail or at risk of becoming frail.
Site 2 (Huntington Hospital): Leaders from nursing, pharmacy, social work/case management, physician, administration, performance improvement, information systems and the Nursing Research/EBP Council will implement, monitor and evaluate the SAFE Care model of care. Two nursing units will be identified for staff training in screening at-risk older adults. One units will be randomly selected to initiate the SAFE Care program. The "comparison" unit staff will screen for at-risk patients and continue usual high standard of care assessments and care planning. Both units will be closely followed with formative and summative evaluation data presented for local and all-site findings.
safe care model of care
SAFE Care Model Site Intervention: Endorse best practices for frail patients; Identify frail patients promptly using multi-dimensional screening and assessments; Employ interprofessional unit-based care team approach to frailty risk reduction during inpatient stay and create post-acute care transitions (PACT) plan recommendations; Develop electronic health record templates for patient-centered interprofessional frailty notes; Communicate PACT plans to primary care providers to promote safe transitions to the ambulatory setting and across the continuum of care. Increase awareness, improve management of frailty, and improve overall health and well-being for adults who are frail or at risk of becoming frail.
Site 3 (Torrance Memorial Hospital): Leaders from nursing, pharmacy, social work/case management, physician, administration, performance improvement, information systems and the Nursing Research/EBP Council will implement, monitor and evaluate the SAFE Care model of care. Two nursing units will be identified for staff training in screening at-risk older adults. One units will be randomly selected to initiate the SAFE Care program. The "comparison" unit staff will screen for at-risk patients and continue usual high standard of care assessments and care planning. Both units will be closely followed with formative and summative evaluation data presented for local and all-site findings.
safe care model of care
SAFE Care Model Site Intervention: Endorse best practices for frail patients; Identify frail patients promptly using multi-dimensional screening and assessments; Employ interprofessional unit-based care team approach to frailty risk reduction during inpatient stay and create post-acute care transitions (PACT) plan recommendations; Develop electronic health record templates for patient-centered interprofessional frailty notes; Communicate PACT plans to primary care providers to promote safe transitions to the ambulatory setting and across the continuum of care. Increase awareness, improve management of frailty, and improve overall health and well-being for adults who are frail or at risk of becoming frail.

Primary Outcomes

Measure
Implementation of SAFE Care model. Decreased LOS
time frame: Up to 24 months
Implementation of SAFE Care model. Reduced use of ICU days
time frame: Up to 24 months
Implementation of SAFE Care model. Reduced hospital complications
time frame: Up to 24 months

Eligibility Criteria

Male or female participants from 18 years up to 110 years old.

Inclusion criteria: Organizational Leadership Nursing Unit Leadership/staff Adults aged 65 years Exclusion criteria: 65 years and older that are on hospice protocols or dying/comfort care protocols.

Additional Information

Official title Systems Addressing Frail Elders (SAFE) Care Implementation
Description Three Magnet hospitals in Los Angeles County (Huntington Hospital, Torrance Memorial Medical Center and Ronald Reagan UCLA Health System) are collaborating on this demonstration and evaluation project (Multiple Case-Study Design). The project will engage interprofessional hospital leadership; provide training and coaching in implementation processes of the SAFE Care model; and track outcome of the SAFE Care model as implemented in the three collaborating site hospitals (three case studies). The investigators hope to contribute to the existing state of the science in dissemination and implementation of evidenced-based innovations. The collective data from the three sites (collected through interviews with hospital leadership and staff and with de-identified patient data on program implementation outcomes) will provide information about the effectiveness of the implementation process and support further dissemination.
Trial information was received from ClinicalTrials.gov and was last updated in July 2016.
Information provided to ClinicalTrials.gov by Cedars-Sinai Medical Center.