Feasibility of the Implementation of the SPARKLe Nurse-led Integrated Transitional Care Model for Children With Complex Care Needs (SPARKLe)
調査の概要
詳細な説明
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.
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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Zurich、スイス、8008
- University Children's Hospital Zurich
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参加基準
適格基準
就学可能な年齢
- 子
健康ボランティアの受け入れ
説明
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
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:他の
- 割り当て:なし
- 介入モデル:単一グループの割り当て
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的: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.
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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.
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Feasibility of the SPARKLe care model among community providers
時間枠:Approximately 2-3 weeks after hospital discharge.
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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.
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Approximately 2-3 weeks after hospital discharge.
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Qualitative perceptions of feasibility of the SPARKLe care model
時間枠:During the 4-month feasibility evaluation period, with family caregiver interviews conducted approximately 2 weeks after hospital discharge.
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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.
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During the 4-month feasibility evaluation period, with family caregiver interviews conducted approximately 2 weeks after hospital discharge.
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Acceptability of the SPARKLe care model among community providers
時間枠:Approximately 2-3 weeks after hospital discharge
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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.
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Approximately 2-3 weeks after hospital discharge
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Qualitative perceptions of acceptability of the SPARKLe care model
時間枠:During the 4-month feasibility evaluation period, with family caregiver interviews conducted approximately 2 weeks after hospital discharge.
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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.
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During the 4-month feasibility evaluation period, with family caregiver interviews conducted approximately 2 weeks after hospital discharge.
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Early adoption of the SPARKLe care model assessed through healthcare professional focus group interviews
時間枠:During the 4-month implementation period
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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.
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During the 4-month implementation period
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Proportion of SPARKLe intervention components implemented as intended
時間枠:From hospital admission through 48 hours after discharge
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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.
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From hospital admission through 48 hours after discharge
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Implementation barriers and facilitators identified through qualitative interviews and focus groups
時間枠:During hospitalization through approximately 3 weeks after discharge
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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.
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During hospitalization through approximately 3 weeks after discharge
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協力者と研究者
捜査官
- 主任研究者:Suzanne Dhaini, PhD, RN、University Children's Hospital, Zurich
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- SPARKLe_2024_Feasibility
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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