None listed
Conditions
Brief summary
Older people in residential aged care are a vulnerable group with a high risk of emergency acute admission to hospital. We expect that many hospitalisations could be avoided by improved management or by providing treatment within the facility, with better outcomes for residents. This study selects facilities with high acute hospitalisation rates for a randomised controlled trial. The intervention will use multidisciplinary teams to support those facilities and up-skill staff using known quality improvement interventions, to test whether acute admissions are reduced and primary care improved.
Interventions
Multidisciplinary teams to support and up-skill facility staff using evidence-based quality improvement interventions.
The supports and services provided will comprise an initial stock-take assessment and development of a facility plan, direct access to a geriatrician and to a geriatric or clinical nurse specialist, multi-disciplinary team meetings to discuss individual cases, provision of targeted education to facility nurses and caregivers (topics include recognition of illness, wound care,
Multidisciplinary teams to support and up-skill facility staff using evidence-based quality improvement interventions. The supports and services provided will comprise an initial stock-take assessment and development of a facility plan, direct access to a geriatrician and to a geriatric or clinical nurse specialist, multi-disciplinary team meetings to discuss individual cases, provision of targeted education to facility nurses and caregivers (topics include recognition of illness, wound care, care planning, end-stage dementia care, nutrition & dehydration, effective family communication), specific coaching with high-risk residents, role modeling of clinical reasoning processes, and provision of benchmarking systems. Facilities will receive 9 months of the intervention. The unit of selection, randomisation and intervention is the facility. The unit of measurement of outcomes is the residents of the participating facilities. Recruitment and randomisation: February to June 2011. Active interventions will be completed by February 2012.
Sponsors
University of Auckland
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Blinded (masking used) (Investigator)
Eligibility
Sex/Gender
All
Age
0 to No maximum
Healthy volunteers
No
Inclusion criteria
The unit of selection, randomisation and intervention is the facility. Facilities providing residential aged care within the greater Auckland region are selected for the trial if they have higher than expected rates of hospitalisation (given number of beds, age of residents etc). All residents living in the participating facilities during the intervention period will be included for the purposes of measuring outcomes.
Exclusion criteria
None
Outcome results
None listed