Post Discharge after Surgery Virtual Care with Remote Automated Monitoring Technology (PVC-RAM): protocol for a randomized controlled trial

After nonelective (i.e., semiurgent, urgent and emergent) surgeries, patients discharged from hospitals are at risk of readmissions, emergency department visits or death. During the coronavirus disease 2019 (COVID-19) pandemic, we are undertaking the Post Discharge after Surgery Virtual Care with Re...

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Bibliographic Details
Published in:	CMAJ open Vol. 9; no. 1; pp. E142 - E148
Main Authors:	McGillion, Michael H, Parlow, Joel, Borges, Flavia K, Marcucci, Maura, Jacka, Michael, Adili, Anthony, Lalu, Manoj M, Yang, Homer, Patel, Ameen, O'Leary, Susan, Tandon, Vikas, Hamilton, Gavin M, Mrkobrada, Marko, Ouellette, Carley, Bird, Marissa, Ofori, Sandra, Conen, David, Roshanov, Pavel S, Harvey, Valerie, Guyatt, Gordon H, Le Manach, Yannick, Bangdiwala, Shrikant I, Arellano, Ramiro, Scott, Ted, Lounsbury, Jennifer, Taylor, Dylan A, Nenshi, Rahima, Forster, Alan J, Nagappa, Mahesh, Lamy, Andre, Peter, Elizabeth, Levesque, Kelsea, Marosi, Kristen, Chaudhry, Sultan, Haider, Shariq, Deuchar, Lesly, LeBlanc, Brandi, McCartney, Colin J L, Schemitsch, Emil H, Vincent, Jessica, Pettit, Shirley M, Paul, James, DuMerton, Deborah, Paulin, Angela Djuric, Simunovic, Marko, Williams, David C, Halman, Samantha, Schlachta, Christopher M, Shelley, Jessica, Harlock, John, Meyer, Ralph M, Graham, Michelle, Shanthanna, Harsha, Parry, Neil, Pichora, David R, Yousef, Haroon, Moloo, Husein, Sehmbi, Herman, Waggott, Melissa, Belley-Cote, Emilie P, Whitlock, Richard, Devereaux, P J
Format:	Journal Article
Language:	English
Published:	Canada Joule Inc. or its licensors 01-01-2021
Subjects:	Adult Aftercare - trends Canada - epidemiology Computers, Handheld - supply & distribution COVID-19 - diagnosis COVID-19 - epidemiology Humans Middle Aged Monitoring, Ambulatory - methods Patient Discharge - standards Postoperative Period Remote Consultation - instrumentation SARS-CoV-2 - genetics User-Computer Interface Canada
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Summary:	After nonelective (i.e., semiurgent, urgent and emergent) surgeries, patients discharged from hospitals are at risk of readmissions, emergency department visits or death. During the coronavirus disease 2019 (COVID-19) pandemic, we are undertaking the Post Discharge after Surgery Virtual Care with Remote Automated Monitoring Technology (PVC-RAM) trial to determine if virtual care with remote automated monitoring (RAM) compared with standard care will increase the number of days adult patients remain alive at home after being discharged following nonelective surgery. We are conducting a randomized controlled trial in which 900 adults who are being discharged after nonelective surgery from 8 Canadian hospitals are randomly assigned to receive virtual care with RAM or standard care. Outcome adjudicators are masked to group allocations. Patients in the experimental group learn how to use the study's tablet computer and RAM technology, which will measure their vital signs. For 30 days, patients take daily biophysical measurements and complete a recovery survey. Patients interact with nurses via the cellular modem-enabled tablet, who escalate care to preassigned and available physicians if RAM measurements exceed predetermined thresholds, patients report symptoms, a medication error is identified or the nurses have concerns they cannot resolve. The primary outcome is number of days alive at home during the 30 days after randomization. This trial will inform management of patients after discharge following surgery in the COVID-19 pandemic and offer insights for management of patients who undergo nonelective surgery in a nonpandemic setting. Knowledge dissemination will be supported through an online multimedia resource centre, policy briefs, presentations, peer-reviewed journal publications and media engagement. ClinicalTrials.gov, no. NCT04344665.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-News-2 ObjectType-Feature-3 content type line 23 The other members of the PVC-RAM Investigators are listed in Appendix 1 (available at www.cmajopen.ca/content/9/1/E142/suppl/DC1).
ISSN:	2291-0026 2291-0026
DOI:	10.9778/cmajo.20200176