Journal article
A stepped-wedge randomised controlled trial assessing the implementation, effectiveness and cost-consequences of the EDDIE+ hospital avoidance program in 12 residential aged care homes: study protocol
BMC Geriatrics, Vol.21(1), pp.1-10
2021
Abstract
Background: Older people living in residential aged care homes experience frequent emergency transfers to hospital. These events are associated with risks of hospital acquired complications and invasive treatments or interventions. Evidence suggests that some hospital transfers may be unnecessary or avoidable. The Early Detection of Deterioration in Elderly residents (EDDIE) program is a multi-component intervention aimed at reducing unnecessary hospital admissions from residential aged care homes by empowering nursing and care staff to detect and manage early signs of resident deterioration. This study aims to implement and evaluate the program in a multi-site randomised study in Queensland, Australia.
Methods: A stepped-wedge randomised controlled trial will be conducted at 12 residential aged care homes over 58 weeks. The program has four components: education and training, decision support tools, diagnostic equipment, and implementation facilitation with clinical systems support. The integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework will be used to guide the program implementation and process evaluation. The primary outcome measure will be the number of hospital bed days used by residents, with secondary outcomes assessing emergency department transfer rates, admission rates, length of stay, family awareness and experience, staff self-efficacy and costs of both implementation and health service use. A process evaluation will assess the extent and fidelity of program implementation, mechanisms of impact and the contextual barriers and enablers.
Discussion: The intervention is expected to improve outcomes by reducing unnecessary hospital transfers. Fewer hospital transfers and admissions will release resources for other patients with potentially greater needs. Residential aged care home staff might benefit from feelings of empowerment in their ability to proactively manage early signs of resident deterioration. The process evaluation will be useful for supporting wider implementation of this intervention and other similar initiatives.
Trial registration: The trial is prospectively registered with the Australia New Zealand Clinical Trial Registry ( ACTRN12620000507987 , registered 23/04/2020).
Details
- Title
- A stepped-wedge randomised controlled trial assessing the implementation, effectiveness and cost-consequences of the EDDIE+ hospital avoidance program in 12 residential aged care homes: study protocol
- Authors
- Hannah E Carter (Author) - Queensland University of TechnologyXing J Lee (Author) - Queensland University of TechnologyAlison Farrington (Author) - Queensland University of TechnologyCarla Shield (Author) - Queensland University of TechnologyNicholas Graves (Author) - National University of SingaporeElizabeth V Cyarto (Author) - The University of QueenslandLynne Parkinson (Author) - University of Newcastle AustraliaFlorin I Oprescu (Author) - University of the Sunshine CoastClaudia Meyer (Author) - Monash UniversityJeffrey Rowland (Author) - The University of QueenslandTrudy Dwyer (Author) - Central Queensland UniversityGillian Harvey (Author) - Queensland University of Technology
- Publication details
- BMC Geriatrics, Vol.21(1), pp.1-10
- Publisher
- BioMed Central Ltd.
- Date published
- 2021
- DOI
- 10.1186/s12877-021-02294-8
- ISSN
- 1471-2318
- Copyright note
- © The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
- Organisation Unit
- University of the Sunshine Coast, Queensland; Engage Research Lab; School of Health and Behavioural Sciences - Legacy; School of Health - Public Health
- Language
- English
- Record Identifier
- 99543308802621
- Output Type
- Journal article
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