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Heart sounds: a pilot randomised trial to determine the feasibility and acceptability of audio recordings to improve discharge communication for cardiology inpatients protocol
  1. Stacey L Schott1,
  2. Michelle D Dannenberg2,
  3. Shayne E Dodge1,
  4. Jesse A Schoonmaker2,
  5. Molly M Caisse2,
  6. Paul J Barr2,
  7. A. James O'Malley1 and
  8. Martha L. Bruce2
  1. 1Department of Cardiovascular Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
  2. 2The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College Geisel School of Medicine, Hanover, New Hampshire, USA
  1. Correspondence to Dr Stacey L Schott; Stacey.L.Schott{at}; Dr Paul J Barr; Paul.J.Barr{at}


Introduction Ineffective hospital discharge communication can significantly impact patient understanding, safety and treatment adherence. This may be especially true for cardiology inpatients who leave the hospital with complex discharge plans delivered in a time-pressured discharge discussion. The goal of this pilot trial was to determine if providing supplemental audio-recorded discharge instructions is feasible and to explore its impact on cardiology patients' ability to understand and self-manage their care .

Methods and analysis We will conduct a parallel-group, randomised controlled trial in adult cardiology inpatients with balanced blocking by a physician. Patients (n=50) will be randomised to usual care (verbal discussion and written summary) or intervention (usual care, plus audio-recorded discharge discussion provided to patients on a portable electronic recording device). Enrolled patients will complete study assessments immediately prior to the discharge discussion, immediately postdischarge discussion and 1 week after hospital discharge by telephone. Primary outcomes include the proportion of eligible providers and inpatients who agree to take part in the trial, the proportion of inpatients who receive the audio recording in accordance with a fidelity checklist, and the proportion who use the audio recording. We will analyse preliminary data about the impact of audio recording on patient activation, health confidence, provider communication ability, adherence and 30-day readmissions.

Ethics and dissemination This trial was approved by The Committee for the Protection of Human Subjects (CPHS) at Dartmouth College (CPHS# 00031211). Findings will be disseminated in scientific journals and at meetings.

Trial registration number NCT03735342

Protocol version 1.0

  • cardiology
  • audio recording
  • hospital discharge
  • self-management
  • understanding

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  • Contributors All authors have provided substantial contributions to the conception or design of the work, or the acquisition, analysis or interpretation of data.

  • Funding This work was supported by a Pilot Award from The Hitchcock Foundation #250-4113.

  • Competing interests Primary investigator (PI) (SS) and co-investigators (MD, SD, JS, MC, MB and JOM) have no financial or competing interests to disclose. The PI (PJB) has no financial interests to disclose but does lead a research group, OpenRecordings, that studies sharing audio/video recordings with patients, caregivers and clinicians and has developed the online sharing technology offered in this project (

  • Patient consent for publication Not required.

  • Ethics approval The research involves human subjects and has received institutional review board approval from the Committee for the Protection of Human Subjects, Dartmouth College (CPHS#00031211).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement There are no data in this work.

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