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Improving quality and safety of shared care between hospitals and general practitioner


- candidate number19539
- NTR NumberNTR4810
- ISRCTNISRCTN no longer applicable
- Date ISRCTN created
- date ISRCTN requested
- Date Registered NTR24-sep-2014
- Secondary IDsMETC UMC Utrecht 13-142/C
- Public TitleImproving quality and safety of shared care between hospitals and general practitioner
- Scientific TitleImproving transitional patient safety: the Transitional Incident Prevention Programme (TIPP).
- ACRONYMTIPP (Transitional Incident Prevention Programme)
- hypothesis1) Implementing TIPP will prevent acute emergency room (ER) visits, rehospitalisations and inappropriate referrals
2) Implementing TIPP improves transitional patient safety culture
3) Although TIPP aims at reducing transitional incidents, implementation will increase the number of reported incidents because of improved awareness of transitional safety
4) Implementing TIPP reduces healthcare costs due to preventing ER visits, rehospitalisations and inappropriate referrals
- Healt Condition(s) or Problem(s) studiedPatient safety, Behaviour, Hospital care, Family practice/general practice, Quality of Health Care
- Inclusion criteriaAdult patients treated by a GP AND

Treated in usual care who are at risk for a transitional incident:
- Patients referred to hospital by the GP OR
- Patients discharged from hospital OR
- Patients that have visited the outpatient clinic at the time of the study.
- Exclusion criteria- Patients outside our research departments
- Patients not treated by a GP within our study population
- mec approval receivedno
- multicenter trialyes
- randomisedno
- groupParallel
- Type2 or more arms, non-randomized
- Studytypeintervention
- planned startdate 1-nov-2014
- planned closingdate1-nov-2016
- Target number of participants1600
- InterventionsTIPP is a multi-faceted intervention containing several components aimed at different aspects of transitional safety, developed using the Intervention mapping approach. The components can be tailored to the specific wishes of each participating setting as actual implementation of a complex intervention largely depends on context
The different facets of transitional safety used in our intervention are: Healthcare process, transitional patient safety culture and patient empowerment
- Primary outcome1) A composite endpoint of: serious adverse events (death, possibility of death or major permanent loss of function), acute visits to the Emergency Room (ER), re-admission within 30 days, and non-appropriate referrals.
2) Number, nature and harm of incidents recorded through a combination of methods: professional- and patient-reported incidents and incidents found in a medical record review.
- Secondary outcome1) Patient perception of transitional patient safety, as measured by the Transitional Risk and Incident Questionnaire (TRIQ) (see Data collection; Patient perceptions on transitional patient safety and incidents).
2) Transitional patient safety culture according to the health care workers, as measured by the TRAnsitional patient safety Culture Evaluation (TRACE) (see Data collection; Transitional patient safety culture).
3) The costs of (avoided) visits to the ER, readmissions, non-appropriate referrals and incidents compared to the direct costs of TIPP.
4) Components of TIPP that were actually implemented and used in the health care chain (process evaluation)
5) Experiences of all stakeholders (health care workers, managers and patients) (user evaluation)
- TimepointsPre-test starts nov 2014; half year period
Start intervention: april 2015; one year period
Posttest: starts april 2016
- Trial web sitewww.juliuscentrum.nl/TIPP
- statusplanned
- CONTACT FOR PUBLIC QUERIES M.A. Melle, van
- CONTACT for SCIENTIFIC QUERIESDr. D.L.M. Zwart
- Sponsor/Initiator Julius Center for Health Sciences and Primary Care
- Funding
(Source(s) of Monetary or Material Support)
Ministry of Health, Welfare and Sports (VWS), Achmea
- PublicationsN/A
- Brief summaryWith this study, we aim to evaluate both the effect of the multi-faceted TIPP programme on transitional safety , as well as its implementation process. The TIPP programme intends to improve transitional patient safety and prevent future incidents.
- Main changes (audit trail)
- RECORD24-sep-2014 - 18-okt-2014


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