NCT03775551: BIDCR-R

Counter-referral System Improvement Collaborative

Completed NA Last updated 23 April 2024

What this trial tests

NA trial testing Improvement cycle in Cardiovascular Diseases in 510 participants. Completed in 1 December 2019.

Timeline

8 June 2018

Primary endpoint
1 December 2019

1 December 2019

Quick facts

Lead sponsor	Institute for Clinical Effectiveness and Health Policy
Phase	NA
Status	Completed
Study type	INTERVENTIONAL
Allocation	randomized
Design	parallel
Masking	none
Primary purpose	health services research
Enrollment	510
Start date	8 June 2018
Primary completion	1 December 2019
Estimated completion	1 December 2019
Sites	10 locations across Argentina

Drugs / interventions tested

• Improvement cycle

Conditions studied

• Cardiovascular Diseases — all drugs for Cardiovascular Diseases →
• Quality Improvement — all drugs for Quality Improvement →

Sponsor

Institute for Clinical Effectiveness and Health Policy

Who can join

18 and older, any sex, with Cardiovascular Diseases or Quality Improvement. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

Coordination between different levels of care has been identified as one of the main components of care among people with chronic diseases. In this sense, an adequate referral and counter-reference system facilitates the management of the care process with timely access to the required referral. The objective of this project is to evaluate the effectiveness of a multicomponent strategy that improves the counter- referral process in patients with cardiovascular diseases in the public health system.

Population: The study will be carried out in selected hospitals of the provinces of Mendoza, Tucumán and Salta in Argentina. Patients who have been hospitalized with a diagnosis of heart failure, hypertension (requires hospitalization) and / or coronary disease (unstable angina) will be included.

Design and methods: a Randomized clinical study by clusters. 10 hospital will be included: 5 will be randomly assigned to receive an intervention to increase the improve counter referral rates (improvement cycles) and 5 to the control branch (usual care). 51 participants will be included in each hospital, in total, 510 participants.

Intervention: An innovative vision is proposed, which combines a participatory and dynamic methodology based on improvement cycles. This approach includes the implementation of participatory learning sessions for health providers, involving the effectors of the design of the intervention. In the intervention branch at least 6 workshops (sessions) will be held with the members of the care system, in order to identify opportunities for improvement oriented to the design and application of an innovative intervention based on best practices. Each one of the sessions will constitute an analysis of the improvement cycle, following the following steps: 1) Selection of participants of the initial workshop; 2) Development of work model based on bibliographic review and initial qualitative phase; 3) Initial workshop with effectors for training in continuous improvement, objectives, interventions and data collection; 4) Learning workshops to discuss results, applicability of interventions and modifications to the work plan; 5) Closing session to evaluate preliminary results and discuss continuity of interventions beyond the project.

Outcomes: 1) consultation in the PHC after hospital discharge; 2) readmission's; 3) consultations in the hospital; 4) follow-up in the PHC; 5) patient perspective (satisfaction).

Publications & conference data

No peer-reviewed publications indexed yet for this trial. Completed trials usually publish results within 12-18 months.