Background
Methods
Study aim
Study design
Setting
Study population
Usual care
Intervention
Development and pilot phase of the intervention
The URGENT care model intervention
Geriatric domain | Variables within the comprehensive geriatric assessment |
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Functional | ❖ Activities of daily living (Katz index [35]) ❖ Fall History [34] ❖ Taking stairs ❖ Pain [34] ❖ Nutritional status: Appetite and weight loss [34] ❖ Alcohol use and smoking ❖ Medication intake ❖ Dyspnea [34] |
Cognitive | ❖ Screening for cognition: three-item word memory and clock drawing (Mini-Cog© [36]) ❖ Orientation in time and place ❖ Attention ❖ Depressive symptoms (3-item screening tool for depression [38]) ❖ Screening for delirium (Confusion Assessment Method [37]) |
Social | ❖ Age ❖ Gender ❖ Living situation (alone, together, other) [34] ❖ Formal care at home (e.g. nurse, meals on wheels, cleaning help, physiotherapist) ❖ Informal care at home (e.g. help from family, friends) ❖ Caregiver burden [34] |
Medical | ❖ Triage priority level (Emergency Severity Index [25]) ❖ Reason for admission ❖ First treating discipline on the ED ❖ Diagnosis ❖ Polypharmacy ❖ ED and hospital use in the last months |
Measures
Baseline variables
Outcome variables
Consent, enrolment and allocation
Data collection
Statistical methodology
Sample size calculation
Propensity model
Comparisons intervention with standard care
Time plan of the study
Trial registration
Data category | Information |
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Primary registry and trial identifying number | ISRCTN registry ISRCTN: 91449949 |
Date of registration in primary registry | 28 July, 2017 |
Secondary identifying numbers | B322201422910 |
Source(s) of monetary or material support | Flemish government agency for Innovation by Science and Technology (file number: 135182) |
Primary sponsor | Flemish government agency for Innovation by Science and Technology (file number: 135182) |
Secondary sponsor(s) | / |
Contact for public queries | Koen Milisen, RN, PhD Academic Centre for Nursing and Midwifery, KU Leuven [koen.milisen@kuleuven.be] [0032 16 37 79 79] |
Contact for scientific queries | Koen Milisen, RN, PhD Academic Centre for Nursing and Midwifery, KU Leuven [koen.milisen@kuleuven.be] [0032 16 37 79 79] |
Public title | Unplanned Readmission prevention by Geriatric Emergency Network for Transitional care (URGENT) |
Scientific title | Unplanned Readmission prevention by Geriatric Emergency Network for Transitional care (URGENT): protocol of a prospective single centre quasi-experimental study |
Countries of recruitment | Belgium |
Health condition(s) or problem(s) studied | Geriatric care needs |
Intervention(s) | A step-by-step geriatric emergency care model is developed, piloted and implemented. Effectiveness of this intervention will be determined by comparing the intervention cohort with a usual care cohort. |
Key inclusion and exclusion criteria | Dutch-speaking, community-dwelling ED patients aged 70 years or older are eligible for enrolment. Patients are excluded if they are transferred from a residential care setting, an inpatient ward or another hospital; have a medical condition that makes an interview impossible; are unable to give informed (proxy) consent or are admitted to the ED on Saturday. Patients to whom the intervention cannot be delivered within 36 hours after ED presentation are excluded, as well. |
Study type | Interventional Quasi-experimental before-after study; sequential design with two cohorts (i.e. usual care cohort and intervention cohort) Primary purpose: prevention |
Date of first enrolment | December 2014 |
Target sample size | 1502 |
Recruitment status | Completed |
Primary outcome(s) | Unplanned emergency department readmission |
Key secondary outcomes | Hospitalization rate, ED length of stay, in-hospital length of stay, higher level of care, functional decline and mortality |