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 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 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

The purpose of this study is to assess the effectiveness and safety of the Dexcom G6 Continuous Glucose Monitoring System when used in non-critically ill hospitalized patients on glucose control. Participants will wear up to three (3) Dexcom sensor configurations, on the arm and on the abdomen.

Hospitalized patients with a stay for a minimum of 2 days in which they are on treatment to manage glucose will participate in the study. There will be no purposeful glucose manipulation since the CGM will be used in blinded mode. Data to determine the accuracy of the CGM in comparison with YSI will be collected through day 5 of CGM wear. Subjects will continue to wear the CGM until their discharge from the hospital up to 10 days of wear. The trial is designed to have at least two blood collection sessions to measure blood glucose on the YSI instrument per patient on different days and times of the day. Blood draws will be performed for periods of 6 hours each at 30-minute intervals on separate days for each participating patient. Day of YSI sessions should be on different sensor wear days. Every attempt will be made to obtain equal numbers of YSI sessions on each day (days 1-5). However, it is anticipated that fewer subjects will remain hospitalized for the full 5 days, so there will likely be more YSI sessions on days 1-3.