The objective of this clinical trial is to investigate the impact of implementing a tool for adjusting the level of diagnostic and therapeutic intensity in the clinical practice of physicians attending hospitalized patients. The goal of this clinical trial is to investigate the impact of a tool for adjusting diagnostic and therapeutic intensity in hospitalized patients. The main question it aims to answer is: Is there a difference in patient mortality when using the aforementioned tool? The participating physicians will be grouped into 4 groups (5 physicians each). Each group will progressively (every 3 months) incorporate the use of the aforementioned tool into their usual clinical practice.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
20
During the intervention periods, participating physicians will integrate into their usual clinical practice a tool for adjusting diagnostic and therapeutic intensity designed by Fontecha-Gómez and colleagues. The tool for adjusting the level of diagnostic and therapeutic intensity classifies patients' profiles into 5 groups based on the recommended level of adjustment.
The participating physicians will carry out the standard clinical practice currently performed in the study centers. This means that during this period, the diagnostic and therapeutic adjustment tool or any similar tool will not be introduced into routine clinical practice.
Consorci Sanitari Alt Penedes i Garraf
Vilafranca del Penedès, Barcelona, Spain
In-hospital Patient Mortality at 90 days from hospital discharge
Percentage of patients who die during hospitalization until 90 days from hospital discharge.
Time frame: 90 days from hospital discharge
In-hospital Patient Mortality at 6 months from hospital discharge
Percentage of patients who die during hospitalization until 6 months from hospital discharge.
Time frame: 6 months from hospital discharge
In-hospital Patient Mortality at 1 year from hospital discharge
Percentage of patients who die during hospitalization until 1 year from hospital discharge.
Time frame: 1 year from hospital discharge
Delirium Incidence
Percentage of patients with delirium occurrence during hospital admission (delirium already present at the time of admission will not be considered). Delirium will be evaluated through Confusion Assessment Method (CAM)
Time frame: hospital discharge, assessed up to day 90
Pressure Ulcer Incidence
Percentage of patients with pressure ulcer occurrence during hospital admission (pressure ulcers already present at the time of admission will not be considered).
Time frame: hospital discharge, assessed up to day 90
Hospital stay
Hospital stay in days
Time frame: hospital discharge, assessed up to day 90
Hospital readmission for any reason
Percentage of patients readmitted for any reason within 30 days of hospital discharge.
Time frame: 30 days from hospital discharge
Hospital readmission for same reason
Percentage of patients readmitted for the same reason within 30 days of hospital discharge.
Time frame: 30 days from hospital discharge
Patients admitted to the Intensive Care Unit (ICU)
Percentage of patients admitted to the ICU during hospitalization
Time frame: hospital discharge, assessed up to day 90
Calls to the "on-call doctor"
Number of calls to the "on-call doctor" during hospital admission
Time frame: hospital discharge, assessed up to day 90
Healthcare expenditure
Descriptive analysis of healthcare expenditure associated with each intervention, using the billing data from the center.
Time frame: through study completion, an average of 1.5 years
Mortality at ICU
Percentage of patients admitted to the ICU
Time frame: hospital discharge, assessed up to day 90
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