Combined Social Worker and Pharmacist Transitional Care Program

Completed · Not applicable

Conditions studied: Patient Admission, Patient Discharge

In brief

In an effort to improve care coordination and reduce hospital readmissions, Rush University Medical Center developed the Combined Social Worker and Pharmacist Program, which targets both the psychosocial and clinical risk factors that can lead to rehospitalization. This study will evaluate the impact of this program on 30-day same hospital readmission rates and total cost of care.

Key facts

Study ID

NCT01503554

Run by

Rush University Medical Center

People needed

100

Starts

2011-04-01

Expected to finish

2011-12-01

Last updated by the study team

2013-05-31

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: accepted.

You may qualify if…

• Age > 18
• Planned discharge to home or home health
• English-speaking
• At least one of the following risk factors:
• Use of high risk medication(s): Anti-coagulant therapy, dual ASA/plavix therapy, anticholinergic agent, digoxin, opioids, psychotropic medications, or erythrocyte stimulating factor
• Clinical risk factor: Depression, fall risk, limited functional capacity, substance abuse, dementia
• Psycho-social risk factor: high care giver burden, family conflict, limited health literacy, lives alone, significant patient stress, transportation concerns, health care scheduling concerns, inadequate emotional support.

You may not qualify if…

• Hospice
• Solid organ transplant
• End-stage renal disease
• Current chemotherapy or radiation therapy

Where it is running

• Rush University Medical Center — Chicago, Illinois, United States

Full record on ClinicalTrials.gov

Trial information comes from ClinicalTrials.gov and is refreshed daily. TrialsForMe does not provide medical care and does not run the studies it lists.