Tools to improve discharge equity: Protocol for the pilot TIDE trial
Background: Written discharge instructions after hospitalization promote patient understanding and positive clinical outcomes. Despite the rising prevalence of patients with non-English language preference (NELP) in the U.S., most hospitals do not routinely provide discharge instructions in their pr...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-02-01
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| Series: | Contemporary Clinical Trials Communications |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451865424001662 |
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| author | Kirsten Austad Cecilia Thai Alegna Zavatti Nhi Nguyen Diana Bautista-Hurtado Patrick Kenney Noelia Lugo Joo H. Lee Howard Lanney Ziming Xuan Erika G. Cordova-Ramos Mari-Lynn Drainoni Brian Jack |
| author_facet | Kirsten Austad Cecilia Thai Alegna Zavatti Nhi Nguyen Diana Bautista-Hurtado Patrick Kenney Noelia Lugo Joo H. Lee Howard Lanney Ziming Xuan Erika G. Cordova-Ramos Mari-Lynn Drainoni Brian Jack |
| author_sort | Kirsten Austad |
| collection | DOAJ |
| description | Background: Written discharge instructions after hospitalization promote patient understanding and positive clinical outcomes. Despite the rising prevalence of patients with non-English language preference (NELP) in the U.S., most hospitals do not routinely provide discharge instructions in their preferred language, thereby placing them at higher risk for medical errors and hospital readmission. Innovative solutions to close this implementation gap at hospital discharge for patients with NELP are needed. The Tools to Improve Discharge Equity (TIDE) intervention leverages communication practices proven effective in addressing communication barriers to create language concordant discharge tools from hospital discharge paperwork. Methods: We present the protocol for a type I hybrid implementation-effectiveness pilot randomized trial. The TIDE intervention includes a translated medication calendar, pictographs, and an audio recording of the discharge instructions in the patient's preferred language. We will recruit an estimated 50 patient participants from the hospital's top four non-English language groups—Spanish, Haitian Creole, Cape Verdean Creole, and Vietnamese—as well as the nurse and in-person interpreter caring for them. Outcomes include patient recall of primary diagnosis and overall understanding of discharge instructions using a newly developed 24-point score, patient experience, implementation measures (acceptability, feasibility, and appropriateness), and clinical effectiveness (including hospital reutilization). A mixed methods evaluation will identify determinants of intervention uptake to guide selection of multi-level implementation strategies to test in a future hybrid type III trial. Discussion: The TIDE intervention is the first hospital discharge intervention designed for patients with NELP. Result will inform future efforts to improve the safety and equity of the hospital discharge process. Trial registration: clinicaltrials.gov NCT05988229 (August 14, 2023) https://classic.clinicaltrials.gov/ct2/show/NCT05988229. |
| format | Article |
| id | doaj-art-b6e4784cd3e24ad0ba7d616f6609a72d |
| institution | Kabale University |
| issn | 2451-8654 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Contemporary Clinical Trials Communications |
| spelling | doaj-art-b6e4784cd3e24ad0ba7d616f6609a72d2025-01-12T05:25:31ZengElsevierContemporary Clinical Trials Communications2451-86542025-02-0143101419Tools to improve discharge equity: Protocol for the pilot TIDE trialKirsten Austad0Cecilia Thai1Alegna Zavatti2Nhi Nguyen3Diana Bautista-Hurtado4Patrick Kenney5Noelia Lugo6Joo H. Lee7Howard Lanney8Ziming Xuan9Erika G. Cordova-Ramos10Mari-Lynn Drainoni11Brian Jack12Department of Family Medicine, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA; Evans Center for Implementation and Improvement Sciences, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA; Corresponding author. 850 Harrison Avenue Dowling 5 Family Medicine, 02118, Boston, MA, USA.Department of Nursing, Boston Medical Center, Boston, MA, USADepartment of Interpreter Services, Boston Medical Center, Boston, MA, USABoston University Chobanian and Avedisian School of Medicine, Boston, MA, USADepartment of Family Medicine, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USADepartment of Family Medicine, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USADepartment of Family Medicine, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USADepartment of Family Medicine, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USADepartment of Family Medicine, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USADepartment of Community Health Sciences, Boston University School of Public Health, Boston, MA, USAEvans Center for Implementation and Improvement Sciences, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA; Department of Pediatrics, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USAEvans Center for Implementation and Improvement Sciences, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA; Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA; Section of Infectious Diseases, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USADepartment of Family Medicine, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USABackground: Written discharge instructions after hospitalization promote patient understanding and positive clinical outcomes. Despite the rising prevalence of patients with non-English language preference (NELP) in the U.S., most hospitals do not routinely provide discharge instructions in their preferred language, thereby placing them at higher risk for medical errors and hospital readmission. Innovative solutions to close this implementation gap at hospital discharge for patients with NELP are needed. The Tools to Improve Discharge Equity (TIDE) intervention leverages communication practices proven effective in addressing communication barriers to create language concordant discharge tools from hospital discharge paperwork. Methods: We present the protocol for a type I hybrid implementation-effectiveness pilot randomized trial. The TIDE intervention includes a translated medication calendar, pictographs, and an audio recording of the discharge instructions in the patient's preferred language. We will recruit an estimated 50 patient participants from the hospital's top four non-English language groups—Spanish, Haitian Creole, Cape Verdean Creole, and Vietnamese—as well as the nurse and in-person interpreter caring for them. Outcomes include patient recall of primary diagnosis and overall understanding of discharge instructions using a newly developed 24-point score, patient experience, implementation measures (acceptability, feasibility, and appropriateness), and clinical effectiveness (including hospital reutilization). A mixed methods evaluation will identify determinants of intervention uptake to guide selection of multi-level implementation strategies to test in a future hybrid type III trial. Discussion: The TIDE intervention is the first hospital discharge intervention designed for patients with NELP. Result will inform future efforts to improve the safety and equity of the hospital discharge process. Trial registration: clinicaltrials.gov NCT05988229 (August 14, 2023) https://classic.clinicaltrials.gov/ct2/show/NCT05988229.http://www.sciencedirect.com/science/article/pii/S2451865424001662Limited English proficiencyNon-English language preferenceImplementation scienceTransitions of careHospital discharge |
| spellingShingle | Kirsten Austad Cecilia Thai Alegna Zavatti Nhi Nguyen Diana Bautista-Hurtado Patrick Kenney Noelia Lugo Joo H. Lee Howard Lanney Ziming Xuan Erika G. Cordova-Ramos Mari-Lynn Drainoni Brian Jack Tools to improve discharge equity: Protocol for the pilot TIDE trial Contemporary Clinical Trials Communications Limited English proficiency Non-English language preference Implementation science Transitions of care Hospital discharge |
| title | Tools to improve discharge equity: Protocol for the pilot TIDE trial |
| title_full | Tools to improve discharge equity: Protocol for the pilot TIDE trial |
| title_fullStr | Tools to improve discharge equity: Protocol for the pilot TIDE trial |
| title_full_unstemmed | Tools to improve discharge equity: Protocol for the pilot TIDE trial |
| title_short | Tools to improve discharge equity: Protocol for the pilot TIDE trial |
| title_sort | tools to improve discharge equity protocol for the pilot tide trial |
| topic | Limited English proficiency Non-English language preference Implementation science Transitions of care Hospital discharge |
| url | http://www.sciencedirect.com/science/article/pii/S2451865424001662 |
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