Enhancing Patient Wellbeing Through Integration of Social Prescribing, Transitional Care, and Place-based Care in Community Hospitals Settings
The study aims to find out whether placed-based care (PBC), helps patients receive better support when they return home after leaving the community hospital, compared with the usual care provided.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
This study addresses the critical need for a rigorous evaluation of PBC as an integrated model of care within community hospital settings. By employing a pragmatic parallel cluster randomised controlled trial design, the study will generate robust evidence on the effectiveness of PBC in real-world practice while minimising contamination at the ward level. The cluster-based design is appropriate given that the intervention is delivered at the ward level and cannot be implemented at the individual patient level without risk of spillover effects.
The use of validated outcome measures, including the CTM-15 as the primary outcome, will enable comprehensive assessment of care transition quality alongside broader outcomes related to patient wellbeing and healthcare utilisation. In addition, the study incorporates a mixed-methods approach, guided by the Practical, Robust Implementation and Sustainability Model (PRISM), to provide insights into implementation processes, mechanisms of action, and contextual factors influencing effectiveness (McCreight et al., 2019; Rabin et al., 2022).
Findings from this study will inform policy and service planning decisions regarding the scaling and sustainability of integrated social prescribing models within Singapore's healthcare system and contribute to the international evidence base on complex transitional care interventions.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: A/Prof Lee Kheng Hock
- Telefonnummer: 69703201
- E-mail: lee.kheng.hock@singhealth.com.sg
Studiesteder
-
-
-
Singapore, Singapore
- Outram Community Hospital
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Singapore, Singapore
- Sengkang Community Hospital
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-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Participant is (male or female) ≥ 50 years of age at Recruitment.
- Participant is expected to discharge to the community.
- Participant is able to converse in either English, Mandarin, or Malay
- Participant is able to sign the written informed consent.
- Participant is considered reliable and capable of adhering to the protocol.
- Participant is able to complete all the questionnaires.
Exclusion Criteria:
- Participant is planned for hospice discharge.
- Participant is planned for nursing home placement, transitional shelter or care facilities
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Sundhedstjenesteforskning
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Aktiv komparator: SCH Place-based Care Intervention Ward
SingHealth Community Hospitals Place-based Care model will be utilised in the ward on top of standard of care treatment. |
Place-based Care (PBC) at SingHealth Community Hospitals represents a significant evolution of these approaches, addressing the limitations of fragmented care by integrating social prescribing with structured transitional care. Within community hospital settings, PBC encompasses five core domains: coordinated specialist outpatient follow-ups, linkage to community resources, medication adherence support, primary care transition planning, and caregiver education and self-care empowerment. This integrated model shifts the conventional discharge process from a primarily episodic and medically driven approach to a comprehensive, person-centred care pathway that incorporates both clinical and social assessment, coordinated care planning, supported transition, and structured follow-up. By embedding social prescribing within the continuum of care, PBC aims to improve both clinical outcomes and patient experience during vulnerable transition periods. |
|
Ingen indgriben: SCH Control Ward
Wards will have normal standard of care treatment. |
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Care Transition Quality (CTM-15)
Tidsramme: T1: 21 Days Post-Discharge
|
The CTM-15 is the primary outcome measure for this study and aligns closely with the five core domains of the PBC intervention: specialist outpatient clinic (SOC) follow-up coordination, community resource linkage, medication adherence support, primary care transition planning, and caregiver and self-care capability. The CTM-15 is a validated 15-item instrument that assesses the quality-of-care transitions from the patient's perspective, capturing key domains such as medication management, understanding of the care plan, preparation for self-care, and coordination across healthcare settings. |
T1: 21 Days Post-Discharge
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Kheng Hock Lee, SingHealth Community Hospitals
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- 2026-1373
- SHF-SCH/26/IFC1-6/01 (Anden identifikator: SCH Health Fund)
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
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