The goal of this clinical trial is to learn whether different ways of providing information and follow-up support after acute kidney injury, also called AKI, can improve care transitions for adults being discharged from the hospital. AKI is a sudden decrease in kidney function that can occur during a hospital stay. The main questions this study aims to answer are: * Does an AKI discharge summary template improve communication about AKI after hospital discharge? * Does a chat-based educational messaging program improve patient understanding of AKI and support follow-up care after hospital discharge? * Researchers will compare usual care, an AKI discharge summary template, a chat-based educational messaging program, and the combination of the discharge summary template plus chat-based messaging. Researchers will compare four groups: * Usual care * An AKI discharge summary template * A chat-based educational messaging program * Both the AKI discharge summary template and the chat-based educational messaging program Participants will complete questionnaires at the start of the study and about 4 weeks after hospital discharge. Participants will also receive a brief phone call about 3 months after discharge, and the research team will review their medical record for information about follow-up care, lab testing, emergency department visits, and hospital readmissions.
Acute kidney injury, also called AKI, is a common complication during hospitalization and is associated with increased risk of poor outcomes after discharge, including incomplete kidney recovery, medication-related safety concerns, emergency department visits, and hospital readmissions. Despite these risks, information about AKI and recommended follow-up care may not always be communicated clearly to patients or outpatient clinicians during the transition from hospital to home. This pilot randomized clinical trial will evaluate the feasibility and preliminary effects of two care transition strategies for adults hospitalized with AKI. The strategies include an AKI discharge summary template designed to improve communication with outpatient clinicians, and a chat-based educational messaging program designed to provide patients with AKI-related information after discharge. Participants will be assigned to one of four study groups: usual care, the AKI discharge summary template, the chat-based educational messaging program, or both the discharge summary template and chat-based messaging. The study will assess whether these strategies are feasible to deliver and acceptable to participants, and whether they improve patient knowledge, perceived preparedness, communication about AKI, and completion of recommended follow-up care after hospital discharge. Participants will complete study questionnaires and allow the research team to review their medical records for information related to kidney function monitoring, follow-up care, emergency department visits, and hospital readmissions. The results of this pilot study will help inform the design of a larger future trial to improve care transitions for patients recovering from AKI.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
160
The AKI discharge summary template provides structured AKI-related information for the hospital discharge summary, including information about the AKI episode and recommended follow-up care. The template is intended to improve communication during the transition from hospital to outpatient care.
The chat-based educational messaging program provides AKI-related educational messages after hospital discharge. Messages are delivered through a secure web-based chat-style interface and are designed to support patient understanding of AKI, post-discharge follow-up, and kidney-related care after hospitalization.
Feasibility: Eligible patient enrollment
Percentage of eligible patients enrolled among those approached.
Time frame: Enrollment period
Feasibility: Participant retention
Percentage of enrolled participants who complete the follow-up assessment.
Time frame: Baseline to 3 months after discharge
Feasibility: Successful delivery of assigned intervention components
Percentage of participants assigned to an intervention arm who receive the assigned intervention component or components as intended, including the AKI discharge summary template and/or chat-based educational messaging program.
Time frame: Hospital discharge through 4 weeks after discharge
AKI Knowledge Score
Participant AKI knowledge score measured using a study questionnaire.
Time frame: 4 weeks after hospital discharge
Patient experience during care transitions
Patient-reported care transition experience measured using a validated transition-of-care instrument, such as the Care Transitions Measure-15.
Time frame: 4 weeks after hospital discharge
Self-management behaviors related to kidney health
Participant-reported self-management behaviors related to kidney health after hospital discharge, assessed using a study questionnaire.
Time frame: 4 weeks after hospital discharge
Adherence to outpatient follow-up appointments
Percentage of participants who complete follow-up with a primary care provider or specialist after hospital discharge, assessed by participant report and/or medical record review.
Time frame: 4 weeks after hospital discharge, and 3 months after hospital discharge
Patient-reported discussion of AKI with outpatient provider
Percentage of participants who report discussing AKI or kidney-related follow-up needs with an outpatient provider after hospital discharge.
Time frame: 4 weeks after hospital discharge
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