Care Transitions in Renal Disease Patients

Status unconfirmed

Conditions studied: Renal Disease

In brief

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.

Key facts

Study ID

NCT01842776

Run by

Fresenius Medical Care North America

People needed

3300

Starts

2013-03-01

Expected to finish

2014-12-01

Last updated by the study team

2013-04-30

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Chronic hemodialysis patients
• All patients admitted to the hospital during the study period

You may not qualify if…

• Patients <18 years old

Where it is running

• Fresenius — Franklin, Tennessee, United States (enrolling)

Full record on ClinicalTrials.gov

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