A protocol for the process evaluation of a multi-centre randomised trial to compare the effectiveness of geriatrician-led admission avoidance hospital at home versus inpatient admission

Makela, P., Godfrey, M., Craduck-Bamford, A., Ellis, G. and Shepperd, S. 2018. A protocol for the process evaluation of a multi-centre randomised trial to compare the effectiveness of geriatrician-led admission avoidance hospital at home versus inpatient admission. Trials. 19, p. 569 569. https://doi.org/10.1186/s13063-018-2929-4

TitleA protocol for the process evaluation of a multi-centre randomised trial to compare the effectiveness of geriatrician-led admission avoidance hospital at home versus inpatient admission
TypeJournal article
AuthorsMakela, P., Godfrey, M., Craduck-Bamford, A., Ellis, G. and Shepperd, S.
Abstract

Background
Attempts to design services to support the delivery of healthcare closer to home have taken various forms as countries respond to an increase in hospital admission rates for older people, who are at risk of hospital-acquired morbidity, prolonged lengths of stay and readmission. Evidence to support the development of these services is limited. We are conducting a process evaluation, alongside a UK multi-site randomised trial, to understand the contexts and practices of implementing geriatrician-led admission avoidance hospital at home services and to explore ways that the intervention might be effective, under what conditions, for whom, and how it differs from inpatient care.

Methods
We are interviewing patients and their caregivers, from sites that are purposively sampled from participating National Health Service (NHS) trusts across the UK. We are also visiting sites to observe local processes and discuss the establishment and running of services with a range of multidisciplinary staff, managers, commissioners, primary care and social services representatives. We aim to interview approximately 36 patients and their caregivers with experience of hospital at home or inpatient services; 12 at each of three sites. We will use a content analysis approach to explore data across participants, services and sites.

Discussion
This process evaluation will enable evaluation of implementation processes prior to knowing trial outcomes. We encompass domains of reach, delivery, change, context and response to the intervention by patients, their carers, health professionals and the health system.

KeywordsProcess evaluation
Hospital at home
Admission avoidance
Article number569
JournalTrials
Journal citation19, p. 569
ISSN1745-6215
Year2018
PublisherBMC
Publisher's version
Digital Object Identifier (DOI)https://doi.org/10.1186/s13063-018-2929-4
Web address (URL)https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-018-2929-4
Publication dates
Published19 Oct 2018
LicenseCC BY 4.0

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