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The Transitional Liver Clinic: Study protocol for a stepped-wedge cluster randomized trial
Lindsay Yoder1, Elliot B Tapper2, Richard Kalman3
1Division of Gastroenterology and Hepatology, Indiana University, Indianapolis, Indiana, USA.
Hepatology Communications
|June 19, 2026
Summary
A new Transitional Liver Clinic (TLC) model using advanced practice providers (APPs) aims to reduce hospital readmissions for advanced liver disease patients. This study assesses its effectiveness in improving patient outcomes and satisfaction.
Area of Science:
- Hepatology
- Transitional Care
- Clinical Trials
Background:
- Advanced liver disease patients face high hospital readmission rates post-discharge.
- Transitional care models show promise in other chronic conditions but need validation in liver disease.
- The Transitional Liver Clinic (TLC) is a tailored model to address these gaps.
Purpose of the Study:
- To evaluate the effectiveness of the TLC intervention in reducing 30-day hospital readmissions for advanced liver disease patients.
- To assess the TLC's impact on quality of life and patient satisfaction.
- To determine if a structured, APP-led model can improve post-discharge care in hepatology.
Main Methods:
- A 45-month, stepped-wedge cluster randomized trial involving up to 1000 patients across 4 academic medical centers.
- Intervention: Post-discharge phone call within 2 business days and a hepatology APP visit within 14 days.
- Primary outcome: 30-day hospital readmission; Secondary outcomes: 90-day readmission, ER visits, mortality, quality of life, patient satisfaction.
Main Results:
- This section is to be filled once the trial concludes and results are available.
Conclusions:
- This multicenter randomized trial will determine the efficacy of a structured, APP-led transitional care model for advanced liver disease.
- If successful, the TLC model offers a potentially scalable solution for post-discharge care in hepatology.