Feasibility of the Implementation of the SPARKLe Nurse-led Integrated Transitional Care Model for Children With Complex Care Needs (SPARKLe)

Children with complex care needs often experience fragmented care during transitions from hospital to home, leading to unmet needs and increased burden on families. The SPARKLe project aims to address this gap through a nurse-led integrated transitional care model. This study evaluates the feasibility of implementing the SPARKLe model in a real-world hospital setting using a mixed-methods design, focusing on implementation outcomes including feasibility, acceptability, adoption, and fidelity.

Study Overview

• Status: Completed
• Conditions: Care Coordination; Transitional Care; Chronic Conditions; Children With Complex Care Needs
• Intervention / Treatment: Behavioral: SPARKLe model

Detailed Description

Children with complex care needs (CCN) often require coordinated care across multiple healthcare providers and settings. Transitions from hospital to home represent particularly vulnerable periods and are frequently characterized by fragmented care, communication gaps, and unclear responsibilities. These challenges can result in unmet needs, duplication of services, increased burden on families, and preventable hospital readmissions.

To address these challenges, the SPARKLe project developed a nurse-led integrated transitional care model designed to improve coordination and continuity of care for children with complex care needs. The model was informed by contextual analysis and stakeholder engagement and is aligned with international frameworks on integrated care as well as national healthcare strategies in Switzerland.

This study evaluates the feasibility of implementing the SPARKLe model in a real-world hospital setting at the University Children's Hospital Zurich. The model includes key components such as early identification of eligible patients, structured needs assessment, active family engagement, standardized information transfer, and follow-up care coordination across settings.

A mixed-methods design was used to assess implementation outcomes, including feasibility, acceptability, adoption, and fidelity. Quantitative data were collected through medical chart reviews, while qualitative data were obtained through interviews with families, focus groups with healthcare professionals, and surveys among community care providers.

The study aims to generate insights into the implementation process, identify barriers and facilitators, and inform further refinement and potential scale-up of the SPARKLe model.

• Study Type: Interventional
• Enrollment (Actual): 6
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Switzerland
  • Zurich, Switzerland, 8008
    • University Children's Hospital Zurich

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Children aged 0 to 16 years with complex care needs
• Admitted to a general pediatric unit at the University Children's Hospital Zurich for more than 24 hours
• Families of eligible children willing to participate in study procedures
• Hospital healthcare professionals involved in the care of included children
• Community healthcare providers involved in post-discharge care of included children

Exclusion Criteria:

• Children receiving care within an already established specialized care program at the hospital (e.g., palliative care or oncology care programs) Families declining participation Hospital professionals not directly involved in the care of included children Community providers not involved in the child's post-discharge care

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: SPARKLe intervention; Participants receive the SPARKLe nurse-led integrated transitional care model designed to improve coordination and continuity of care for children with complex care needs during the transition from hospital to home.	Behavioral: SPARKLe model; The SPARKLe model is a nurse-led integrated transitional care intervention for children with complex care needs. It includes key components such as early identification of eligible patients, structured needs assessment, active family engagement, standardized information transfer, and coordination of follow-up care across healthcare settings.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Feasibility of the SPARKLe care model among community providers	Feasibility of the SPARKLe care model from the perspective of community providers was assessed using four survey items adapted from the Feasibility of Intervention Measure (FIM), together with selected items informed by the Normalization Measure Development (NoMAD) instrument. NoMAD-informed items assessed coherence, cognitive participation, and collective action related to implementation and integration of the SPARKLe care model into routine practice. Survey items were rated on a five-point Likert scale ranging from strongly disagree to strongly agree.	Approximately 2-3 weeks after hospital discharge.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Qualitative perceptions of feasibility of the SPARKLe care model	Feasibility was explored among family caregivers and hospital health professionals through semi-structured individual interviews and interprofessional focus group interviews. Questions examined the practicality of implementing individual SPARKLe care model components, including identification of children with complex care needs, needs assessment and transition planning, family engagement, communication with community providers, and post-discharge follow-up. Qualitative data were analyzed using rapid qualitative analysis and summarized as themes related to perceived feasibility.	During the 4-month feasibility evaluation period, with family caregiver interviews conducted approximately 2 weeks after hospital discharge.
Acceptability of the SPARKLe care model among community providers	Acceptability of the SPARKLe care model from the perspective of community providers was assessed using four survey items adapted from the Acceptability of Intervention Measure (AIM). Survey items were rated on a five-point Likert scale ranging from strongly disagree to strongly agree.	Approximately 2-3 weeks after hospital discharge
Qualitative perceptions of acceptability of the SPARKLe care model	Acceptability was explored among family caregivers and hospital health professionals through semi-structured individual interviews and interprofessional focus group interviews. Questions examined satisfaction with and perceptions of the usefulness, appropriateness, and overall experience of the SPARKLe care model. Qualitative data were analyzed using rapid qualitative analysis and summarized as themes related to perceived acceptability.	During the 4-month feasibility evaluation period, with family caregiver interviews conducted approximately 2 weeks after hospital discharge.
Early adoption of the SPARKLe care model assessed through healthcare professional focus group interviews	Early adoption was explored among hospital health professionals through semi-structured interprofessional focus group interviews. Questions adapted from the Evidence-Based Practice Attitude Scale (EBPAS) examined initial uptake, engagement with the intervention, willingness to use the SPARKLe care model, perceived value of the intervention, and intentions to continue SPARKLe-related care coordination activities in routine practice. Qualitative data were analyzed using rapid qualitative analysis and summarized as themes related to early adoption.	During the 4-month implementation period
Proportion of SPARKLe intervention components implemented as intended	Implementation fidelity was assessed using a structured fidelity assessment evaluating whether individual SPARKLe intervention components were implemented as intended for each participating child with complex care needs. The assessment covered the five core components of the SPARKLe care model: (1) identification of children with complex care needs, (2) needs assessment and individualized transition planning, (3) family engagement, (4) structured information transfer to community providers, and (5) post-discharge follow-up within 48 hours. Implementation of each component was assessed and summarized descriptively as the number and proportion of participating cases in which the respective component was implemented as intended.	From hospital admission through 48 hours after discharge
Implementation barriers and facilitators identified through qualitative interviews and focus groups	Implementation barriers and facilitators related to the SPARKLe care model were explored qualitatively through semi-structured individual interviews with family caregivers and interprofessional focus group interviews with hospital health professionals. Questions addressed experiences with individual SPARKLe intervention components, interdisciplinary collaboration, communication across care settings, family involvement, care coordination processes, and organizational factors influencing implementation. Qualitative data were analyzed using rapid qualitative analysis to identify barriers and facilitators relevant to implementation and intervention refinement.	During hospitalization through approximately 3 weeks after discharge

Collaborators and Investigators

• Sponsor: University Children's Hospital, Zurich
• Investigators: Principal Investigator: Suzanne Dhaini, PhD, RN, University Children's Hospital, Zurich

Study record dates

Study Major Dates

• Study Start (Actual): April 1, 2024
• Primary Completion (Actual): July 31, 2024
• Study Completion (Actual): December 31, 2024

Study Registration Dates

• First Submitted: April 16, 2026
• First Submitted That Met QC Criteria: August 31, 2026
• First Posted (Actual): September 3, 2026

Study Record Updates

• Last Update Posted (Actual): September 3, 2026
• Last Update Submitted That Met QC Criteria: August 31, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Implementation; Integrated Care; Care Coordination; Feasibility Study; SPARKLe; Children with complex care needs; Tranisitional Care
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Pathological Conditions, Signs and Symptoms; Chronic Disease
• Other Study ID Numbers: SPARKLe_2024_Feasibility

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No