Clinical Trials

The purpose of this study is to evaluate whether a video visit with an advanced practice provider (APP (Nurse practitioner or Physician assistant) within 7 days after discharge from Hospital Internal Medicine services at Saint Marys Hospital will increase patient adherence with medication, self-management, and home support post-hospital discharge (primary outcome). We will also evaluate subsequent 7- and 30- day emergency department visits and hospital re-admissions (secondary outcome). Patients enrolled in the study will undergo 1:1 randomization: video-visit + usual care (intervention arm) and usual care (control arm).  Participants in each arm will participate in a telephone survey 4-6 days after hospital discharge reviewing discharge medication and self-management.

The purpose of this study is to evaluate the relationships between patient-provider plan of care agreement following hospital ward rounds and patient readiness for discharge.

The objective of this proposal is to assess blood-plasma volume (TBV-PV) status quantitatively in patients with DHF admitted to hospital for volume management, and to determine how effective standard diuretic therapy is in achieving euvolemia and the impact of their quantitated volume status at the time of hospital discharge on heart failure related morality and re-hospitalizations. Thus, to determine if quantitative blood volume analysis could potentially serve as an effective tool to guide more effective in-hospital diuretic therapy to achieve better outcomes in patients hospitalized with clinically identified volume overload.

The investigators believe that the lessons learned from studies regarding 30-day and 90-day readmission are primarily due to failure of early symptom recognition, and medical error. Through the aid of remote monitoring and early symptom detection, the hypothesis for the current proposal is that interventions can be recommended in an earlier, remote fashion that may result in earlier post-surgical discharge, prevent decompensation, and prevent increased readmissions that have been associated with decreased LOS in other surgical populations.

The primary purpose of this study is to collect data on patient-identified factors which contribute to readmissions to the Mayo Clinic Hospital Medicine Services within 30 days of discharge.

The primary purpose of this study is to evaluate the correlation between Non-Invasive Venous Waveform Analysis (NIVA) score and Total Blood Volume (TBV) in Heart Failure (HF) patients on admission for decompensation and at discharge after diuresis.

The purpose of this study is to evaluate the safety and effectiveness of the Centralized Lung Evaluation System (CLES) in enabling evaluation of potential donor lungs not otherwise used for transplant into subjects with end stage, survival-limiting lung disease in need of lung transplantation. This will be accomplished by evaluating subject survival at the later of 6 months or hospital discharge post-transplant.

Over a third of those who survive critical illness suffer from symptoms of anxiety, depression, or post-traumatic stress disorder (PTSD) after leaving the intensive care unit (ICU). This is twice as high as the rates of PTSD in combat veterans. The strongest risk factor is memories of frightening experiences and delusions (something that is very common during critical illness, when patients feel that something is real when it is actually not). Patients can hear speech even when sedated, yet there is no systematic communication with the critically ill while they receive life-saving medical treatments. We think that lack of real-time communication with patients contributes to their traumatic memories, because patients may not understand why they experience something painful, and what is happening to them. We therefore propose to modify an already existing intervention called ICU diaries to provide this real time communication. Currently it is one of the most commonly used interventions and consists of the treating team and family members writing down the daily events in a diary that the patient receives sometime after the hospital discharge. Unfortunately, ICU diaries have not shown consistent results, perhaps because when the patient reads about their ICU stay, they have already formed traumatic memories of that experience. Aloud reading of ICU diaries in real-time creates a method for systematically ensuring delivery of patient-orientated communication for ICU patients. This communication may therefore prevent negative psychological sequela in ICU survivors by orienting patients to their surroundings and situation; encouraging accurate memories and recall of the ICU experience. Prior to performing a larger study powered to evaluate the efficacy of this intervention on ICU survivor outcomes, we will perform an initial feasibility study to improve upon the current proposed protocol. We plan to assess feasibility via enrollment of 30 patients into a prospective cohort study where compliance with completing diary tasks can be measured and input from important stakeholders such as patients, patient families, room nurses, and physical/occupational therapists can be obtained and evaluated. This study is to determine the feasibility of providing psychological support to ICU patients through reading aloud standard of care daily diary entries by the care team which will be evaluated through feedback from patients and their family members

The purpose of this study is to establish a registry that will address the data gap regarding the course of NSTEMI (Non-ST-Elevation Myocardial Infarction) between ED (Emergency Department) arrival and diagnostic angiography in detail, by characterizing and following the ED and peri-ED use of advanced OAP (Oral Anti-Platelet) agents. In addition to exploring ED treatment patterns and success of both ischemic and bleeding risk stratification prior to definition of the coronary anatomy, data generated via the UPSTREAM registry will allow plausible attribution of ischemic and bleeding outcomes to pre-catheterization antiplatelet therapy in the management of NSTEMI. This registry further seeks to demonstrate that contemporary use of upstream ticagrelor is associated with an economically-sound utilization of hospital resources, and smooth transition of care into the outpatient, secondary prevention setting for the first 30 days after hospitalization. Finally, it will allow characterization of patient selection factors and processes for ticagrelor vs alternative OAP agents, carrying out that descriptive comparison through discharge. Patients transferred in to an UPSTREAM hospital are eligible for inclusion, but the timing for OAP agent administration and diagnostic catheterization begin with ED care at the first hospital.

The purpose of this study is to assess intravascular volume heterogeneity in relation to neuroendocrine profiles in patients admitted to hospital with decompensated acute on chronic systolic heart failure with serial assessments post-discharge