Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Providing acute care at home for medicine patients is a well-studied care model. Providing acute care at home immediately following major surgery is less well understood. The investigators seek to demonstrate the noninferiority of care at home versus the hospital for patients undergoing bariatric sleeve gastrectomy.
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control, Care in the Hospital | No Intervention | After bariatric sleeve gastrectomy, patients receive their care in the hospital, as usual. | |
| Intervention, Care in the Home | Experimental | After bariatric sleeve gastrectomy, patients receive their care in the home. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Home hospital | Other | Acute care provided at home, including nurse/paramedic visits, physician visits, laboratory testing, imaging, continuous monitoring, 24/7 urgent visits, and specialty consultation. |
| Measure | Description | Time Frame |
|---|---|---|
| Length of Stay | Days spent hospitalized | From day of admission to day of discharge, assessed up to 10 months |
| Measure | Description | Time Frame |
|---|---|---|
| Motion | Percent of the day lying down | From day of admission to day of discharge, assessed up to 10 months |
| Cost, direct | Presented as a percentage |
| Measure | Description | Time Frame |
|---|---|---|
| Rate of emergency department presentation | Emergency department presentation without admission | From day of discharge to 30 days later, assessed up to 10 months |
| Rate of readmission | Readmission to the hospital |
Inclusion Criteria:
Exclusion Criteria:
All existing home hospital criteria apply, with the following taking precedent for this specific condition
Comorbidities
History of
Medications
Allergy to ketorolac
Prolonged QTc
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Brigham and Women's Faulkner Hospital | Boston | Massachusetts | 02130 | United States | ||
| Brigham and Women's Hospital |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 16330791 | Background | Leff B, Burton L, Mader SL, Naughton B, Burl J, Inouye SK, Greenough WB 3rd, Guido S, Langston C, Frick KD, Steinwachs D, Burton JR. Hospital at home: feasibility and outcomes of a program to provide hospital-level care at home for acutely ill older patients. Ann Intern Med. 2005 Dec 6;143(11):798-808. doi: 10.7326/0003-4819-143-11-200512060-00008. | |
| 33479931 |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| From day of admission to day of discharge, assessed up to 10 months |
| Opioid use | Morphine milligram equivalents used | From day of admission to day of discharge, assessed up to 10 months |
| From day of discharge to 30 days later, assessed up to 10 months |
| BodyQ Score | Sum of the following three transformed scales (total of 300 points): Satisfaction with information (100 points) + Satisfaction with doctor/surgeon (100 points) + Satisfaction with medical team (100 points) | From day of admission to day of discharge, assessed up to 10 months |
| Picker experience questionnaire - 15 | 0-15 points, more points better | From day of admission to day of discharge, assessed up to 10 months |
| Global experience score | 0-10 points, more points better | From day of admission to day of discharge, assessed up to 10 months |
| Pain score | Pain score on scale of 0-10, fewer points better | From day of admission to day of discharge, assessed up to 10 months |
| Number of complications | Sum of the complications included in the metabolic and bariatric surgery accreditation and quality improvement program | From day of admission to day of discharge, assessed up to 10 months |
| Bed-days saved | Acute care bed days not required due to the intervention | From day of admission to day of discharge, assessed up to 10 months |
| Stage 2 diet | Time to resumption of stage 2 diet, measured in hours | From day of admission to day of discharge, assessed up to 10 months |
| 400mL intake | Time to intake of 400mL, measured in hours | From day of admission to day of discharge, assessed up to 10 months |
| 6 hours out of bed on post operative day 1 | Time to 6 hours out of bed on post operative day 1, measured in hours | From day of admission to day of discharge, assessed up to 10 months |
| Boston |
| Massachusetts |
| 02130 |
| United States |
| Levine DM, Pian J, Mahendrakumar K, Patel A, Saenz A, Schnipper JL. Hospital-Level Care at Home for Acutely Ill Adults: a Qualitative Evaluation of a Randomized Controlled Trial. J Gen Intern Med. 2021 Jul;36(7):1965-1973. doi: 10.1007/s11606-020-06416-7. Epub 2021 Jan 21. |
| 33909002 | Background | Bryan AF, Levine DM, Tsai TC. Home Hospital for Surgery. JAMA Surg. 2021 Jul 1;156(7):679-680. doi: 10.1001/jamasurg.2021.0597. No abstract available. |