Specialty: Ageing, Primary sub-specialty: Ageing
Conditions
Interventions
The intervention is implemented at the level of the whole care home.
The BHiRCH programme is a complex intervention, with 4 key components. These are:
1. Early Warning
Sponsors
University College London
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. The study implements an enhanced version of usual care and because of the clustered nature of the setting this will be implemented across the care home. All residents will be invited to be involved in the collection of individual level outcome data. 2. Aged 65 and older
Exclusion criteria
Exclusion criteria: 1. Residents receiving end of life treatment or palliative care, under the age of 65, those who are not english speaking or those who have stated they do not wish to be involved in research 2. Care partners will be excluded from the project, and no more data will be collected if their relative/friend passes away during the project
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Reduction in avoidable acute hospital admissions for respiratory infections, urinary tract infections, dehydration and exacerbation of chronic heart failure. The number of hospital admissions will be recorded from care home records. Residents who have been hospitalised and have consented to individual level data collection will be eligible for analysis for this outcome. Their care records will be analysed using the SIRR tool, and this data will be further assessed by an expert panel of geriatricians to identify whether the hospitalisation was avoidable. This assessment will be carried out shortly after the hospitalisation of any resident. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Establish whether resident consent procedures allow the collection of sufficient individual level data using the number of residents who have consented at the end of the Pilot Trial 2. Effectiveness of the implementation strategy is assessed using qualitative data on barriers and facilitators to implementation. This will be recorded from telephone calls with Practice Development Champions on a monthly basis, and from qualitative interviews with care home staff at the end of the Pilot Trial 3. fidelity to the intervention is assessed using research field notes from telephone calls with Practice Development Champions on a monthly basis, and from qualitative interviews with care home staff at the end of the Pilot Trial 4. The level of nursing home staff engagement with the intervention is assessed using qualitative interviews with care home staff at the end of the Pilot Trial, and the number of recorded usage of the intervention tools (on a monthly basis) 5. Sustainability of the intervention outside the context of a trial is assessed using qualitative interviews with nursing home staff (at the end of the Trial) and researcher field notes on support provided, from monthly telephone calls with Practice Development Champions 6. Potential primary and secondary outcomes for a definitive trial are assessed using an analysis of the completeness of data at the end of the pilot trial 7. Cost and outcome data is measured using an economic evaluation based on prescription medication usage and the CSRI tool, collected monthly from residents who have consented 8. Probability of the intervention being cost-effectiveness is assessed using an analysis of prescription medication usage, CSRI data and staff time spent on the intervention, collected monthly from resident care home data and telephone calls with staff 9. Key cost components through economic ana | — |
Countries
United Kingdom
Contacts
Public ContactMurna Downs
Outcome results
None listed