Follow Home Visits After Discharge

Summary

The study aims to assess whether a follow home visit after discharge of frail elderly patients from Nykøbing Falster Hospital reduces the risk of readmission within 180 days.

Staff from the hospital ward identifies patients fulfilling the inclusion criteria and refers the patients to two project nurses at the hospital (follow home team). One of the project nurses gets the informed consent from the patient, or in case of a patient who is not able to give informed consent, from the family and general practitioner. The patient is then randomized to intervention (follow home visit after discharge) or control.

In the intervention group, the hospital project nurse and the patient meets with the municipal nurse in the patient's home on the same day the patient is being discharged from the hospital. During this visit the discharge from the hospital and the actual functioning of the patient in his own surroundings is reviewed, using a structured assessment.

Conditions

• Discharge Planning
• Readmission
• Hospital
• Frail Elderly Patients

Interventions

OTHER

Review of follow home visits after discharge from Nykøbing Falster Hospital

The intervention is follow home visits which is randomized and is an intervention that is assigned by the investigator.

Sponsors & Collaborators

• Region Zealand

  collaborator OTHER

• Nykøbing Falster County Hospital

  collaborator OTHER

• Guldborgsund Municipality

  collaborator UNKNOWN

• Lolland Municipality

  collaborator UNKNOWN

• Vordingborg Municipality

  collaborator UNKNOWN

• Zealand University Hospital

  lead OTHER

Principal Investigators

• Maurice Antoine Lembeck, MD · Region Zealand, Nykøbing Falster Hospital

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

65 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2013-01-31

Primary Completion

2014-12-31

Completion

2015-01-31

Countries

• Denmark

Study Locations