Trial reportBMC health services research2019
Implementation of a billable transitional care model for stroke patients: the COMPASS study.
Trial report in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02588664 (Early Supported Discharge for Improving Functional Outcomes After Stroke), which is not on this map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Early Supported Discharge for Improving Functional Outcomes After Stroke
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Implementation Outcomes and Their Determinants for Hospital-Led Care Coordination Interventions Targeting Patients With Complex Care Needs: A Qualitative Systematic Review.Journal of clinical nursing · 2026Pooled it
- Impact of a Comprehensive Transitional Care Management Model on Use of Community-Based Rehabilitation After Stroke.Journal of the American Heart Association · 2026Trial
- Influence of continuity of care on self-management ability and quality of life in outpatient maintenance hemodialysis patients.Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy · 2022Trial
- Hospital Readmissions and Mortality Among Fee-for-Service Medicare Patients With Minor Stroke or Transient Ischemic Attack: Findings From the COMPASS Cluster-Randomized Pragmatic Trial.Journal of the American Heart Association · 2021Trial
- Implementation of a Transitional Care Model for Stroke: Perspectives From Frontline Clinicians, Administrators, and COMPASS-TC Implementation Staff.The Gerontologist · 2020Trial
- Transitional care interventions and outcome measures in stroke rehabilitation: a scoping review.Disability and rehabilitation · 2026Review
- Feasibility, Fidelity and Acceptability of a Person-Centred Care Transition Support Intervention for Stroke Survivors: A Non-Randomised Controlled Study.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- Disparities in transitions of acute stroke care: The transitions of care stroke disparities study methodological report.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2023Observational
- Adaptation of a Personalized Electronic Care Planning Tool for Cancer Follow-up Care: Formative Study.JMIR formative research · 2023Article
- Effect of "Internet + tertiary hospital-primary hospital-family linkage home care" model on self-care ability and quality of life of discharged stroke patients.American journal of translational research · 2023Article
- Recommendations for the Design and Delivery of Transitions-Focused Digital Health Interventions: Rapid Review.JMIR aging · 2022Review
- Fostering the implementation of transitional care innovations for older persons: prioritizing the influencing key factors using a modified Delphi technique.BMC geriatrics · 2022Article
- Article
- Challenges and Facilitators in Implementing a Focus on Function in Structured Clinical Settings.The Public policy and aging report · 2022Article
- Article
- Hospital to Home Transition for Patients With Stroke Under Bundled Payments.Archives of physical medicine and rehabilitation · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
20 authors.
Funding
Abstract
backgroundThe COMprehensive Post-Acute Stroke Services (COMPASS) pragmatic trial compared the effectiveness of comprehensive transitional care (COMPASS-TC) versus usual care among stroke and transient ischemic attack (TIA) patients discharged home from North Carolina hospitals. We evaluated implementation of COMPASS-TC in 20 hospitals randomized to the intervention using the RE-AIM framework.
methodsWe evaluated hospital-level Adoption of COMPASS-TC; patient Reach (meeting transitional care management requirements of timely telephone and face-to-face follow-up); Implementation using hospital quality measures (concurrent enrollment, two-day telephone follow-up, 14-day clinic visit scheduling); and hospital-level sustainability (Maintenance). Effectiveness compared 90-day physical function (Stroke Impact Scale-16), between patients receiving COMPASS-TC versus not. Associations between hospital and patient characteristics with Implementation and Reach measures were estimated with mixed logistic regression models.
resultsAdoption: Of 95 eligible hospitals, 41 (43%) participated in the trial. Of the 20 hospitals randomized to the intervention, 19 (95%) initiated COMPASS-TC. Reach: A total of 24% (656/2751) of patients enrolled received a billable TC intervention, ranging from 6 to 66% across hospitals. IMPLEMENTATION: Of eligible patients enrolled, 75.9% received two-day calls (or two attempts) and 77.5% were scheduled/offered clinic visits. Most completed visits (78% of 975) occurred within 14 days. Effectiveness: Physical function was better among patients who attended a 14-day visit versus those who did not (adjusted mean difference: 3.84, 95% CI 1.42-6.27, p = 0.002). Maintenance: Of the 19 adopting hospitals, 14 (74%) sustained COMPASS-TC.
conclusionsCOMPASS-TC implementation varied widely. The greatest challenge was reaching patients because of system difficulties maintaining consistent delivery of follow-up visits and patient preferences to pursue alternate post-acute care. Receiving COMPASS-TC was associated with better functional status.
trial registrationClinicalTrials.gov number: NCT02588664. Registered 28 October 2015.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.