Inpatient Facililty DiagnosesNCT05876429
Optimizing the Safety of Inter-Hospital Transfer
A study testing New Standardized Accept Note and Existing Transfer Patient Admission Process in people with Inpatient Facililty Diagnoses, run by Brigham and Women's Hospital at 1 site in United States.
Trial summary
This proposal aims to design, implement and rigorously evaluate a standardized accept note in a population of patients that have high frequency of IHT, including patients transferred to the general medical (GMS), cardiology and oncology services at a large tertiary care hospital. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Inpatient Facililty Diagnoses
- What is being tested?
- New Standardized Accept Note and Existing Transfer Patient Admission Process
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 1,658 participants
- Where
- 1 siteUnited States
- Study dates
- 17 Aug 2020to 30 Jun 2023
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- source of admission is inpatient transfer from another acute care hospital
- admitted to general medical service
- admitted to cardiology service
- admitted to oncology service
- admitted to ICU service
- age >= 18
Who cannot join
- source of admission is other than inpatient transfer
- admitted to service other than listed above
- age < 18
Trial locations and contacts
1 site in 1 country.
United States1 site
Brigham & Women's Hospital
Boston, Massachusetts, 02115
About this study
This proposal aims to design, implement and rigorously evaluate a standardized accept note in a population of patients that have high frequency of IHT, including patients transferred to the general medical (GMS), cardiology and oncology services at a large tertiary care hospital. This study will improve scientific knowledge by quantifying the patient safety impact of an intervention to improve communication of essential clinical information during IHT. If shown effective, the results of this study can be used to improve clinical practice by establishing evidence-based communication guidelines for broad dissemination. We will also establish technical feasibility by successfully implementing this tool within our EHR (Epic, Verona, WI), allowing for feasible adoption and dissemination to other institutions with similar EHR capabilities. Lastly, we will address malpractice risk by investigating a strategic intervention aimed at reducing known contributors to patient harm during IHT, a high-risk transition in care that involves transfer of high-acuity patients between providers, settings and systems of care.
Read the detailed description
Inter-hospital transfer (IHT), commonly performed to provide patients with more specialized care, involves transfer of patients between providers, settings and systems of care, leaving these patients vulnerable to the risks of discontinuity of care. Standardized communication tools, which have been successful at reducing patient harm among other similar hospital-based care transitions (i.e., intra-hospital patient handoffs), have been under-utilized during IHT to-date, leaving the process largely non-standardized and variable.
The overall goal of this proposal is to optimize patient safety during IHT to GMS, cardiology and oncology services, collectively comprising nearly 50% of all IHT to Brigham and Women's Hospital (BWH), by leveraging our pilot work to design, implement and rigorously evaluate a standardized communication tool to be used during IHT. We propose the following Specific Aims to accomplish this goal:
Aim 1. Utilize pilot data and stakeholder input to revise the standardized accept note.
Aim 2a. Implement the revised standardized accept note for all patients transferred from another acute care hospital to the GMS, cardiology, and oncology inpatient services at BWH.
Aim 2b. Shift the responsibility of documentation of the accept note from a diffuse group of individual clinicians to a small group of dedicated nurses within the Access Center.
Aim 3. Prospectively evaluate the impact of the intervention on patient safety outcomes, including: clinician-reported medical errors and adverse events, length of stay after transfer, rapid-response or code within 6-hours of transfer, ICU-transfer within 24-hours of transfer, and 3-day and in-hospital mortality.
- Conditions
- Inpatient Facililty Diagnoses
- Being tested
- New Standardized Accept Note, Existing Transfer Patient Admission Process
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
New Standardized Accept NoteOther
A standardized accept note for transfer patients will be implemented, after stakeholder engagement and subsequent finalization.
Existing Transfer Patient Admission ProcessOther
Maintain existing transfer patient admission processes, across GMS, Cardiology, and Oncology services.
| Study group | Role | What they receive |
|---|---|---|
| Pre-Intervention: Current Transfer Process | Active comparator | Control: Transfer patients are admitted per usual based on existing processes for GMS, Cardiology, and Oncology services. Data collection assesses clinician reported feedback on the logistics for each patient transfer, and issues along the transfer supply chain. Receives: Other: Existing Transfer Patient Admission Process |
| Post-Intervention: Implementing Standardized Accept Note | Experimental | Intervention Arm: After engaging stakeholders and finalizing a standardized accept note for transfer patients, appropriate staff will be trained on the use of the note and the note will be implemented in the transfer patient admission process. Data collection will assess clinician reported feedback on the logistics for each patient transfer, and issues along the transfer supply chain, post-intervention. Receives: Other: New Standardized Accept Note |
What is being measured
The primary outcome is the main question the study is designed to answer.
clinician-reported medical errors and adverse events
Medical errors and adverse events measured as the total number of medical errors per patient
Measured: Up to 2 weeks
Secondary outcomes (8)
Presence of any adverse event after transfer
Clinician reported adverse events for each transferred patient
Measured: up to 2 weeks
Preventable adverse event after transfer
Measured: up to 2 weeks
Ameliorable adverse event after transfer
Measured: up to 2 weeks
Length of stay of hospitalization after transfer
Measured: up to 2 weeks
ICU-transfer within 24 hours of transfer
Measured: Up to 24 hours
In-hospital mortality
Measured: up to 30 weeks
presence of accept note
Measured: Up to 24 hours
timeliness of accept note
Measured: Up to 24 hours
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted25 May 2023
- Study start17 Aug 2020
- Primary completion15 Jul 2022
- Study completion30 Jun 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Inpatient Facililty DiagnosesStudies of the same condition, open and under way.
- More trials run by Brigham and Women's HospitalThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Non-randomised
- Intervention model
- Sequential
- Masking
- None (open label)
- Enrolment
- 1,658 participants (actual)
Sponsor and investigators
- Lead sponsor
- Brigham and Women's Hospital
- Sponsor type
- University, hospital or other
- Collaborators
- Crico
- Responsible party
- Principal investigator, Stephanie Mueller, Brigham and Women's Hospital
- Investigators
- Stephanie Mueller, M.D., M.P.H., Principal investigator, Brigham and Women's Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05876429
- Sponsor's protocol ID
- 2020P001945
- Status last verified
- Jan 2026
- First submitted
- 6 Apr 2023
- Last updated
- 23 Jan 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 23 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Optimizing the Safety of Inter-Hospital Transfer
- ClinicalTrials.gov ID
- NCT05876429
- Acronym / sponsor ID
- 2020P001945
- Conditions
- Inpatient Facililty Diagnoses
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 1,658 participants (actual)
- Lead sponsor
- Brigham and Women's HospitalUniversity, hospital or other
- Collaborators
- Crico
- Study start
- 17 Aug 2020 (actual)
- Primary completion
- 15 Jul 2022 (actual)
- Study completion
- 30 Jun 2023 (actual)
- First posted
- 25 May 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This proposal aims to design, implement and rigorously evaluate a standardized accept note in a population of patients that have high frequency of IHT, including patients transferred to the general medical (GMS), cardiology and oncology services at a large tertiary care hospital. This study will improve scientific knowledge by quantifying the patient safety impact of an intervention to improve communication of essential clinical information during IHT. If shown effective, the results of this study can be used to improve clinical practice by establishing evidence-based communication guidelines for broad dissemination. We will also establish technical feasibility by successfully implementing this tool within our EHR (Epic, Verona, WI), allowing for feasible adoption and dissemination to other institutions with similar EHR capabilities. Lastly, we will address malpractice risk by investigating a strategic intervention aimed at reducing known contributors to patient harm during IHT, a high-risk transition in care that involves transfer of high-acuity patients between providers, settings and systems of care.
Detailed description
Inter-hospital transfer (IHT), commonly performed to provide patients with more specialized care, involves transfer of patients between providers, settings and systems of care, leaving these patients vulnerable to the risks of discontinuity of care. Standardized communication tools, which have been successful at reducing patient harm among other similar hospital-based care transitions (i.e., intra-hospital patient handoffs), have been under-utilized during IHT to-date, leaving the process largely non-standardized and variable.
The overall goal of this proposal is to optimize patient safety during IHT to GMS, cardiology and oncology services, collectively comprising nearly 50% of all IHT to Brigham and Women's Hospital (BWH), by leveraging our pilot work to design, implement and rigorously evaluate a standardized communication tool to be used during IHT. We propose the following Specific Aims to accomplish this goal:
Aim 1. Utilize pilot data and stakeholder input to revise the standardized accept note.
Aim 2a. Implement the revised standardized accept note for all patients transferred from another acute care hospital to the GMS, cardiology, and oncology inpatient services at BWH.
Aim 2b. Shift the responsibility of documentation of the accept note from a diffuse group of individual clinicians to a small group of dedicated nurses within the Access Center.
Aim 3. Prospectively evaluate the impact of the intervention on patient safety outcomes, including: clinician-reported medical errors and adverse events, length of stay after transfer, rapid-response or code within 6-hours of transfer, ICU-transfer within 24-hours of transfer, and 3-day and in-hospital mortality.
Study design
- Primary purpose
- Health services research
- Allocation
- Non-randomised
- Intervention model
- Sequential
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Pre-Intervention: Current Transfer Process | Active comparator | Other: Existing Transfer Patient Admission ProcessControl: Transfer patients are admitted per usual based on existing processes for GMS, Cardiology, and Oncology services. Data collection assesses clinician reported feedback on the logistics for each patient transfer, and issues along the transfer supply chain. |
| Post-Intervention: Implementing Standardized Accept Note | Experimental | Other: New Standardized Accept NoteIntervention Arm: After engaging stakeholders and finalizing a standardized accept note for transfer patients, appropriate staff will be trained on the use of the note and the note will be implemented in the transfer patient admission process. Data collection will assess clinician reported feedback on the logistics for each patient transfer, and issues along the transfer supply chain, post-intervention. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- source of admission is inpatient transfer from another acute care hospital
- admitted to general medical service
- admitted to cardiology service
- admitted to oncology service
- admitted to ICU service
Key exclusion criteria (3 listed)
- source of admission is other than inpatient transfer
- admitted to service other than listed above
- age < 18
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| New Standardized Accept NoteA standardized accept note for transfer patients will be implemented, after stakeholder engagement and subsequent finalization. | Other | Post-Intervention: Implementing Standardized Accept Note |
| Existing Transfer Patient Admission ProcessMaintain existing transfer patient admission processes, across GMS, Cardiology, and Oncology services. | Other | Pre-Intervention: Current Transfer Process |
Primary outcome
clinician-reported medical errors and adverse events
Time frame: Up to 2 weeks
Medical errors and adverse events measured as the total number of medical errors per patient
8 secondary outcomes
Presence of any adverse event after transfer
Time frame: up to 2 weeks
Preventable adverse event after transfer
Time frame: up to 2 weeks
Ameliorable adverse event after transfer
Time frame: up to 2 weeks
Length of stay of hospitalization after transfer
Time frame: up to 2 weeks
ICU-transfer within 24 hours of transfer
Time frame: Up to 24 hours
In-hospital mortality
Time frame: up to 30 weeks
presence of accept note
Time frame: Up to 24 hours
timeliness of accept note
Time frame: Up to 24 hours
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 23 Jan 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Stephanie Mueller, M.D., M.P.H. principal investigator
Brigham and Women's Hospital
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing New Standardized Accept Note and Existing Transfer Patient Admission Process in people with Inpatient Facililty Diagnoses, run by Brigham and Women's Hospital at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 23 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
clinician-reported medical errors and adverse events (time frame: Up to 2 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Jan 2026.