Screening frailty for older patients, double checking injectable medication administration and performing medication reconciliation at discharge.
Conditions
Interventions
The FRAM intervention includes:
- FRAM interviews with healthcare professionals,
- a feedback meeting with healthcare providers of the participating ward to discuss WAI and WAD,
- an interview with
Sponsors
None listed
Eligibility
Inclusion criteria
Inclusion criteria: All Dutch hospitals are invited to participate in the study. Specific wards are eligible for participation within each theme: - Frail older patients: internal medicine and surgery wards. - High-risk medication: ICUs and internal medicine and surgery wards. - Medication reconciliation: cardiology and orthopedics wards.
Exclusion criteria
Exclusion criteria: Hospitals that are undergoing drastic changes (mergers, implementation electronic health record system, etc.) are not eligible for participation.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary outcomes are: 1. A process evaluation of the different care processes by comparing the Work-as-Done vs. the Work-As-Imagined according to the FRAM method. 2. A qualitative description of whether the FRAM intervention has provided healthcare professionals with more insight into the different care processes and whether team reflection has stimulated behavioral change among healthcare professionals and substantive changes in the process. 3. A quantitative description of team learning and behavior change by quantifying the proposed and implemented changes of the care process and protocols. | — |
Secondary
| Measure | Time frame |
|---|---|
| The secondary outcomes are: 1. Employee resilience among healthcare professionals and compliance of several Safety Indicators (SIs). Employee resilience will be measured using the EmpRes scale, a nine-item scale. 2. Compliance will be measured by collecting the following SIs: - Percentage of discharged patients of 18 years and older where medication reconciliation at discharge was performed. - Percentage of patients of 70 years and older who are screened for frailty. - Percentage of high-risk medication administrations in which a second check during administration was correctly performed. 3. A process evaluation will be conducted using the COM-B model. One month after a wedge has ended, the contact person of the ward will be interviewed to evaluate the process. These interviews will be analyzed with the help of the 'behaviour change wheel’ and 3 essential conditions of the COM-B model: Capability, Opportunity, Motivation. | — |
Contacts
Public ContactLiselotte van Dijk
Nivel
Outcome results
None listed