NCT01842776

Care Transitions in Renal Disease Patients

• Status: Unknown
• Phase: —
• Study type: Observational
• Enrollment: 3,300 (estimated)
• Sponsor: Fresenius Medical Care North America · Industry
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

The goal of this pilot is to reduce the 30-day hospital readmission rate for dialysis patients. It is a quality improvement project that consistent of 4 "tracks." Tracks 1 \& 2: Implement use of checklists of activities for staff to complete when patients are admitted to the hospital, and post-hospitalization with emphasis on fluid assessment, nutrition management, patient coaching, and communication between institutions. Track 3: Work with physicians to develop process to individualize post-hospitalization dialysis orders and improve medication reconciliation. Track 4: Use a renal Care Transitions Case Manager to follow patients in the hospital and 30 days post-hospitalization to facilitate care and patient coaching.

Conditions

• Renal Disease

Timeline

• Start date: 2013-03-01
• Primary completion: 2014-06-01
• Completion: 2014-12-01
• First posted: 2013-04-30
• Last updated: 2013-04-30

Locations

1 site across 1 country: United States