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Behavioural Intervention

At-Home Skilled Nursing Care for Rehabilitation

N/A
Recruiting
Research Sponsored by Brigham and Women's Hospital
Eligibility Criteria Checklist
Specific guidelines that determine who can or cannot participate in a clinical trial
Must have
Community-dwelling before hospitalization
>=18 years old
Must not have
Environmental: Home has insufficient accessible space to sleep, eat, and perform rehabilitative therapy
Clinical: Requires more than one assist (unless the family can provide additional 24/7 assistance)
Timeline
Screening 3 weeks
Treatment Varies
Follow Up admission to rehab until discharge from rehab, no more than 6 months
Awards & highlights

Summary

This trial will compare the care provided to patients at home by a technology-enabled team to the care provided in a traditional skilled nursing facility setting. Patients who are usually sent to a skilled nursing facility after being

Who is the study for?
This trial is for adults over 18 who need skilled nursing facility care after hospitalization. It's for stroke patients not covered by insurance, those recommended for rehabilitative therapy, and surgical trauma patients able to bear weight and transfer with minimal help. Participants must have lived at home before hospitalization and be likely to return home after short-term rehab.
What is being tested?
The study compares receiving skilled nursing facility care at home versus traditional in-facility care post-hospitalization. Patients are randomly placed into two groups: one receives tech-supported home care, while the other gets standard in-facility services.
What are the potential side effects?
Since this trial involves non-medical interventions (home-based vs. facility-based care), it does not have typical medication side effects; however, risks may include issues related to the adequacy of care received at home compared to a skilled nursing facility.

Eligibility Criteria

Inclusion Criteria

You may be eligible if you check “Yes” for the criteria below
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I was living at home before I was hospitalized.
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I am 18 years old or older.

Exclusion Criteria

You may be eligible for the trial if you check “No” for criteria below:
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My home lacks the space needed for sleep, eating, and therapy.
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I need help from more than one person for daily activities, unless my family can assist me all the time.
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I need a tube in my nose for feeding.
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I have a psychiatric condition that is not currently being treated effectively.
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I need special medication that I don't already have at home.
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I need blood transfusions.
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I need to visit a specialist at least three times a week.
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I require hemodialysis.
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I need help learning to care for my new ostomy.
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I need frequent help to clear my airways and rely on a machine to help me breathe.
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I need nutrition through an IV.
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I or my family caregiver cannot talk on the phone.
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I am on methadone and pick it up daily.
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I need treatment that involves getting medicine through a vein.
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I have had a traumatic brain injury.
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I need daily nursing care for a wound or medical device.
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I need help from more than one person due to my spine injury.
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My chance of being independent after a brain hemorrhage is less than 75%.

Timeline

Screening ~ 3 weeks
Treatment ~ Varies
Follow Up ~admission to rehab until discharge from rehab, no more than 6 months
This trial's timeline: 3 weeks for screening, Varies for treatment, and admission to rehab until discharge from rehab, no more than 6 months for reporting.

Treatment Details

Study Objectives

Outcome measures can provide a clearer picture of what you can expect from a treatment.
Primary outcome measures
Change in activities of daily living between admission to rehab and discharge from rehab
Secondary outcome measures
30-day readmission or 30-day mortality
Patient experience with care
Percent time supine per day
+1 more

Trial Design

2Treatment groups
Active Control
Group I: Usual skilled nursing facility careActive Control1 Intervention
Control subjects will receive care at a skilled nursing facility as per usual.
Group II: Rehab at homeActive Control1 Intervention
Intervention subjects will receive care in their home from a specialized care team.

Find a Location

Who is running the clinical trial?

Boston Medical CenterOTHER
395 Previous Clinical Trials
875,229 Total Patients Enrolled
Brigham and Women's HospitalLead Sponsor
1,653 Previous Clinical Trials
11,490,735 Total Patients Enrolled
Cambridge Health AllianceOTHER
61 Previous Clinical Trials
23,359 Total Patients Enrolled
~200 spots leftby Jun 2025