To assess the feasibility of the Virtual Ward in six pre-defined sub-cohorts of non-elective hospitalized patients within the current Dutch healthcar
ID
Source
Brief title
Condition
- Other condition
Synonym
Health condition
meerdere cohorten met niet planbare zorg (denk aan decompensatio cordis, bacteriele infecties, virale infecties, dehydratie, methylprednison bij transplantnier-afstoting)
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
To assess the feasibility of the Virtual Ward across six pre-defined
sub-cohorts of non-elective hospitalized patients by determining the percentage
of
patients who provide informed consent and are successfully transferred to the
Virtual Ward, with a feasibility threshold set at 30% for this pilot phase
(adherence). Feasibility is determined
per sub-cohort
Secondary outcome
1. a. To asses the percentage of suitable patients (who meet in- and exclusion
criteria)
who have been invited to participate in the study by the researchers (reach)
b. To asses the percentage of patients providing informed consent for Virtual
Ward
(reach)
2. To document the time frame from study inclusion to transfer to the Virtual
Ward.
3. To document clinical outcomes which can guide future implementation:
• What type of patient is included (i.e. baseline characteristics as shown in
8.1.3.).
• The generation of notifications during monitoring, including the type and
quantity,
as well as the actions taken after a notification is generated
• Number and time of contact moments between patient and virtual ward
employee/treating physician.
• Length of stay in the hospital ward.
• Length of stay in the Virtual Ward.
• Adverse (safety) events during admission in the Virtual Ward.
• Readmission rate to the hospital.
4. To explore experiences, barriers and facilitators about patients and
healthcare
providers to use the Virtual Ward through structured interviews to guide future
implementation strategies.
Background summary
Patients undergo extensive diagnostics and treatment adjustments during the
early days of their hospitalization, which may become less imperative as their
admission progresses. If a patient's vital signs stabilize after the initial
hospitalization, and they only necessitate "less urgent" hospital care, an
option is to transfer them to the Virtual Ward and thereby creating hospital
capacity. This telemedicine-driven model presents an alternative to the
conventional in-patient care approach. In the Virtual Ward, patients continue
to receive care under supervision of the hospital physician but from the
comfort of their own homes. This means the hospital oversees the monitoring of
vital signs, performing diagnostics and treatment in the patient's home
environment. A growing body of evidence supports the safety of "Virtual Wards."
However, although proven safe, its feasibility remains uncertain.
Study objective
To assess the feasibility of the Virtual Ward in six pre-defined sub-cohorts of
non-elective hospitalized patients within the current Dutch healthcar
Study design
This is a single-center prospective cohort trial with 6 sub-cohorts.
Intervention
Intervention (if applicable):Patients will be discharged to the virtual ward
with monitoring, diagnostics, and treatment at home.
Study burden and risks
Patients who are admitted to the virtual ward can benefit from recovering in a
home environment. Potential risks are that they are not within reach of the
treating physicians in case of an adverse event. Patients need to fill in
questionnaires and measure their own vital signs. There are no additional
invasive interventions patients would need to undergo by participating in this
study
Dr. Molewaterplein 40
Rotterdam 3015GD
NL
Dr. Molewaterplein 40
Rotterdam 3015GD
NL
Listed location countries
Age
Inclusion criteria
1. Written informed consent is obtained from the patient
2. The patient is >= 18 years old
3. The patient has a family member or caregiver (over 18 years old) who lives
at the same address as the patient.
4. The patient has access to transportation 24 hours a day, with a maximum
travel time of 45 minutes to reach the hospital.
5. The patient (or their family member/caregiver) has a mobile phone with data
and call-ing capabilities
6. The patient (or their family member/caregiver) possesses sufficient digital
skills.
Exclusion criteria
1. The patient is unable to communicate in Dutch
2. The patient has been diagnosed with dementia, psychosis, or another disorder
that se-verely impairs their judgment capability.
3. The patient has a Clinical Frailty score (CSF)>6
4. The patient is receiving end of life care.
5. The patient is addicted to drugs or alcohol, excluding smoking.
6. The patient's pain is inadequately treated, requiring intravenous pain
medication.
7. The patient has received interventions within the past 24 hours to improve
vital pa-rameters and the MEWS score at the time of transfer to the Virtual
Ward is >2.
8. The patient is undergoing oxygen therapy at a flow rate > 5 liters per minute
9. Patient complexity or treatment intensity is not feasible in the Virtual
Ward; home care, diagnostics, or treatment are not suitable for the Virtual
Ward setting due to current or-ganizational constraints.
10. The physician determines that treatment in the Virtual Ward is not safe for
the patient for any reason; for example, when the treating physician concludes
that the patient is not sufficiently self-reliant in terms of self-care for
treatment in the setting of Virtual Ward.
11. The treating physician or the investigator expects that the patient will
spend less than 24 hours in the Virtual Ward.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL85516.078.24 |