Optimising health information exchange during aged care transfers for people living in Residential Aged Care (RAC)

Name of the intervention: Digital health summary of information considered critical during the medical transfer of residents living in RAC Materials used: The project team has developed generic implementation materials (e.g. signs, checklists, manuals, worksheets) and training materials, and then tailored them for each trial site (e.g. training delivery platform and format, physical space and layout, alert systems) in partnership with organisational representatives of each trial site. During the preparatory phase of the trial and at least 1 month before the intervention is due to start, trial sites will be provided with awareness raising materials (e.g. posters, email announcements, newsletter content, videos) to alert staff, residents and families of the trial. The project facilitator will supervise digital training and provide face-to-face training for participating trial sites. Digital training/face-to-face training will be delivered via 2x1 hour workshops conducted one month prior to implementation at each participating RAC site. Attendance to training is not mandatory, however their uptake of participation and involvement will be monitored via audit of website analytics and review of training attendance logs. Procedures: The NASSS (non-adoption, abandonment, scale-up, spread, sustainability) framework has been adopted to co-design health information considered critical during aged care transfer and guide implementation. The intervention will be delivered as part of usual clinical care, recruitment and analysis for the intervention will be at the RAC site level. Staff from 3 participating RAC sites have helped co-design the digital interface and demonstrated commitment to testing digital health summary in their aged care homes including engagement with Peninsula Health, Ambulance Victoria and GPs using Outcome Health throughout the intervention. Opt-out consent processes for residents has been developed in consultation with participating RAC sites. Who will deliver the intervention: A digital health summary will be set up for each resident at participating RAC sites, except where a resident has chosen to opt out of the project. Health information presented in the digital health summary includes most recent emergency contact information, presence of Advance Care Directive, allergies, medication precautions, usual level of alertness, mobility requirements, presence of behaviour support plan and post discharge information. Staff from the RAC site, ambulance, Peninsula Health, and GPs using the outcome health system will be able to access the user interface within their own secure clinical systems. Once the resident’s information profile has been set up it will be able to be viewed by RAC staff at any time including prior to a transfer or in other situations where a person requires care. The anticipated time required to review the digital health summary prior to a transfer event is around 5 to 10mins. Participating aged care home residents and their nominated informal carers will have access to review information and have full visibility over the information that is being communicated between healthcare providers. Adherence and usage of digital health summary during the intervention at each participating trial site will be monitored using website analytics. Mode of delivery: The digital health summary will be hosted on a secure virtual server and accessed via a simple web interface on a PC, laptop, tablet or smart phone. Access will be given to the technology only to authorised end users who are part of the trial (e.g. RAC staff, residents, selected paramedics, relevant hospital staff) and resident profiles will be created so that end users can access the system during the intervention period. The RAC staff involved during a transfer event will be available to answer any additional questions to paramedics/health professionals as required and part of usual clinical care. Digital health summary is designed to compliment not replace existing documentation and processes. Health information presented in digital health summary will be confirmed with the RAC on a fortnightly basis to ensure consistency during the intervention period and/or updated whenever a health change is noted following hospital admission/discharge and/or triggered by events while in RAC. Number of times: Each trial site will be given access to the digital health summary platform during the 3 month intervention phase. The expectation is that the digital health summary will be used during an ambulance call out or a transfer event to the hospital. The project facilitator will contact the trial site weekly or fortnightly to check on progress and support needs. System improvement activities will be conducted during each intervention phase. Duration, intensity or dose: At the end of their three-month intervention phase at a trial site there will be a one month evaluation phase prior to commencement of the trial at another trial site, Location: Three RAC homes located in the Peninsula Health catchment are participating in the study. The digital health summary will be implemented into each of the participating RAC sites, Peninsula Health systems and relevant community care programs, Ambulance Victoria and GPs using Outcome Health systems. The intervention will be embedded in daily clinical practice and only residents from participating RAC will be part of the trial.