Clinical Trial


Transitional Care Programme




Randomised, controlled quality improvement study 
Research Sites


Bart’s Health NHS Trust


To assess whether the Transitional Care Programme (TCP) published by Robertson et al.10 can decrease length of stay, improve discharge efficiency, and reduce readmissions in elective neurosurgical patients.
Number of Participants 200 patients enrolled in the TCP, and 200 controls


Main Inclusion Criteria


Patients will be eligible for the Transitional Care Program if scheduled for elective neurological surgery by any one of the participating consultant surgeons, and are expected to have a discharge disposition to home. Patients will be randomized into two groups: the TCP intervention or standard of care.


Statistical Methodology and Analysis (if applicable)


Outcomes Assessment:

Outcome measures will be collected through intake forms, longitudinal data collection, hospital medical records, and billing statements. Primary outcome measures will be 30-day unplanned hospital readmissions (to the same institution as the index operation) and length of hospital stay. Secondary analysis will include time of discharge. Morning discharge will be emphasized as part of an institutionally guided effort to facilitate patient progression.


Statistical Analysis:

Outcomes will be evaluated with multivariable regression after including age, sex, operation, and Charlson Comorbidity Index score as covariates to prevent selection bias. We will assess length of stay, time of discharge, readmission rates, and hospital cost.


Proposed Start Date Patient Enrolment: March 15th, 2018



Proposed End Date May 15th, 2019
Study Duration


14 months



Chief Investigator

Mr. Edward McKintosh
MBBS, FRCS(SN), PhD Neurosurgeon,

Barts Health NHS Trust, Royal College of Surgeons

Phone: +44 (0)20 7234 2991

Nursing Staff

Ruth McGeough