Status:
COMPLETED
Combined Social Worker and Pharmacist Transitional Care Program
Lead Sponsor:
Rush University Medical Center
Conditions:
Patient Admission
Patient Discharge
Eligibility:
All Genders
18+ years
Phase:
NA
Brief Summary
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 psychosoc...
Detailed Description
If a patient is enrolled in the Combined Social Worker and Pharmacist Program their care will differ from usual care in a number of different ways. First, while the patient is in the hospital, an inte...
Eligibility Criteria
Inclusion
- 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.
Exclusion
- Hospice
- Solid organ transplant
- End-stage renal disease
- Current chemotherapy or radiation therapy
Key Trial Info
Start Date :
April 1 2011
Trial Type :
INTERVENTIONAL
Allocation :
ACTUAL
End Date :
December 1 2011
Estimated Enrollment :
100 Patients enrolled
Trial Details
Trial ID
NCT01503554
Start Date
April 1 2011
End Date
December 1 2011
Last Update
May 31 2013
Active Locations (1)
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1
Rush University Medical Center
Chicago, Illinois, United States, 60612