Evidence-based intervention to reduce avoidable hospital admissions in care home residents (the Better Health in Residents in Care Homes (BHiRCH) study): Protocol for a pilot cluster randomised trial

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2019-05Author
Sampson, E.L.Feast, A.
Blighe, Alan J.
Froggatt, K.
Hunter, R.
Marston, L.
McCormack, B.
Nurock, S.
Panca, M.
Powell, Catherine
Rait, G.
Robinson, L.
Woodward-Carlton, Barbara
Young, J.
Downs, Murna G.
Keyword
Avoidable hospital admissionsCare home residents
Intervention
Better Health in Residents in Care Homes study
BHiRCH study
Rights
© Author(s) (or their employer(s)) 2019. This is an open access article distributed in accordance with the Creative Commons CC-BY license (https://creativecommons.org/licenses/by/4.0/)Peer-Reviewed
YesOpen Access status
openAccessAccepted for publication
2019-03-28
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Show full item recordAbstract
Acute hospital admission is distressing for care home residents. Ambulatory care sensitive conditions, such as respiratory and urinary tract infections, are conditions that can cause unplanned hospital admission but may have been avoidable with timely detection and intervention in the community. The Better Health in Residents in Care Homes (BHiRCH) programme has feasibility tested and will pilot a multicomponent intervention to reduce these avoidable hospital admissions. The BHiRCH intervention comprises an early warning tool for noting changes in resident health, a care pathway (clinical guidance and decision support system) and a structured method for communicating with primary care, adapted for use in the care home. We use practice development champions to support implementation and embed changes in care. Methods and analysis: Cluster randomised pilot trial to test study procedures and indicate whether a further definitive trial is warranted. Fourteen care homes with nursing (nursing homes) will be randomly allocated to intervention (delivered at nursing home level) or control groups. Two nurses from each home become Practice Development Champions trained to implement the intervention, supported by a practice development support group. Data will be collected for 3 months preintervention, monthly during the 12-month intervention and 1 month after. Individual-level data includes resident, care partner and staff demographics, resident functional status, service use and quality of life (for health economic analysis) and the extent to which staff perceive the organisation supports person centred care. System-level data includes primary and secondary health services contacts (ie, general practitioner and hospital admissions). Process evaluation assesses intervention acceptability, feasibility, fidelity, ease of implementation in practice and study procedures (ie, consent and recruitment rates).Version
Published versionCitation
Sampson EL, Feast A, Blighe A et al (2019) Evidence-based intervention to reduce avoidable hospital admissions in care home residents (the Better Health in Residents in Care Homes (BHiRCH) study): protocol for a pilot cluster randomised trial. BMJ Open. 9(5): e026510.Link to Version of Record
https://doi.org/10.1136/bmjopen-2018-026510Type
Articleae974a485f413a2113503eed53cd6c53
https://doi.org/10.1136/bmjopen-2018-026510