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Psychosocial risk screening in the inpatient care of physically ill patients: study protocol for a feasibility study
Stephan Christoph Feder1,2, Zuhal Simsek3, Joe J Simon3
1Department of General Internal Medicine, Psychosomatics and Psychotherapy, Heidelberg University Hospital, Heidelberg, Germany StephanChristoph.Feder@med.uni-heidelberg.de.
Insights
This pilot study assesses the feasibility of integrating psychosocial risk screening into hospital admissions to reduce patient length of stay. The goal is to prepare for a larger trial on improving care for physically ill patients with mental health comorbidities.
Area of Science:
- Medical and Health Services Research
- Psychosomatic Medicine
- Health Services Management
Background:
- Patients with physical illnesses experience longer hospital stays when they have mental health comorbidities, especially with severe physical multimorbidity.
- Integrating psychosocial risk screening at admission could address psychosomatic and social care needs early, potentially reducing length of stay.
- Implementation challenges include organizational factors (staff workload, process integration) and patient factors (screening acceptance).
Purpose of the Study:
- To assess the feasibility of implementing an integrated psychosocial risk screening and follow-up pathway in a hospital setting.
- To gather data to inform the design of a larger confirmatory trial.
- To determine if the screening and referral process is practical for patients and healthcare staff.
Main Methods:
- A single-center, randomized feasibility study conducted on a pilot ward.
- Patients were assigned to an intervention group (tablet-based psychosocial screening) or a control group.
- The intervention group received screening by physicians or medical students, with referrals to psychosomatic consultation or social work if positive and consented.
Main Results:
- The primary feasibility criterion is an informed consent rate of 30% of eligible patients.
- The study period is planned for 4 months.
- Descriptive statistics will be used to analyze the feasibility data.
Conclusions:
- This feasibility study is a crucial preparatory step for a full-scale confirmatory trial.
- Successful implementation could lead to improved care pathways for patients with complex health needs.
- Findings will guide the optimization of screening and follow-up processes in clinical practice.
Background:
The length of hospital stay for patients with physical illnesses is longer for those with mental health comorbidity, particularly in the presence of severe physical multimorbidity. Integrating psychosocial risk screening at hospital admission, with a subsequent care pathway, could address psychosomatic and social care needs early and reduce length of stay. However, implementation may be hindered by organisational factors such as increased staff workload and timely integration into existing processes. In addition, patient factors such as low acceptance of screening and follow-up may affect uptake. This pilot study aims to assess the feasibility of implementing this integrated approach to screening and follow-up in preparation for a confirmatory trial.
Methods:
The present study is a single centre, randomised feasibility study conducted on a pilot ward. Patients will be enrolled and assigned to the intervention or the control group. Only the intervention group will receive tablet-based psychosocial risk screening conducted by ward physicians or medical students in their practical year. If the psychosomatic screening is positive and the patient agrees, he or she is referred to the psychosomatic consultation service. If the social service screening is positive, the patient will be seen by a social worker. The main objective of this study is to assess the feasibility of conducting a full-sized confirmatory trial. An informed consent rate of 30% of eligible patients is set as the feasibility criterion. A study period of 4 months is planned for the feasibility study. The feasibility study will be analysed using descriptive statistics.
Ethics And Dissemination:
The study protocol was approved by the Ethics Committee of the Medical Faculty of Heidelberg University (S-301/2024) on 24 May 2024. The results of this feasibility study will be published in a peer-reviewed journal.
Trial Registration Number:
NCT06651164.
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