Implementing an allied health team intervention to improve the care of older adults in the emergency department: protocol for a process evaluation

Marica Cassarino, Úna Cronin, Katie Robinson, Rosie Quinn, Fiona Boland, Marie E Ward, Rosa MacNamara, Margaret O'Connor, Gerard McCarthy, Damien Ryan, Rose Galvin, Marica Cassarino, Úna Cronin, Katie Robinson, Rosie Quinn, Fiona Boland, Marie E Ward, Rosa MacNamara, Margaret O'Connor, Gerard McCarthy, Damien Ryan, Rose Galvin

Abstract

Introduction: Health and social care professionals (HSCPs) have increasingly contributed to enhance the care of patients in emergency departments (EDs), particularly for older adults who are frequent ED attendees with significant adverse outcomes. For the first time, the effectiveness of a HSCP team intervention for older adults in the ED has been tested in a large randomised controlled trial (Clinicaltrials.gov, NCT03739515), providing an opportunity to explore the implementation process for this type of intervention. This protocol describes a process evaluation that will to investigate the implementation, delivery and impact of an HSCP team intervention in the ED.

Methods and analysis: Using the Medical Research Council Framework for process evaluations, we will employ a mixed-methods approach to provide a description of the process of implementation and delivery of the HSCP intervention in the ED, evaluate its fidelity, dose and reach and explore the perceptions of key staff members in relations to the mechanisms and contexts of impact at the levels of individuals, physical environment, operations, communication and the broader hospital and healthcare system.

Ethics and dissemination: Ethical approval for this study was received from the HSE Mid-Western Regional Hospital Research Ethics Committee (Ref: 103/18). All participants will be invited to read and sign a written consent form prior to participation. The results of this review will be disseminated through publication in a peer-review journal and presented at relevant conferences.

Keywords: allied health; emergency department; health service delivery; implementation; interdisciplinary care; process evaluation.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
HSCP intervention logic model. ED, emergency department; HSCP, health and social care professionals; MSW, medical social worker; PT, physiotherapist; OT, occupational therapist.

References

    1. Craig P, Dieppe P, Macintyre S, et al. . Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ 2008;337:a1655 10.1136/bmj.a1655
    1. Moore GF, Audrey S, Barker M, et al. . Process evaluation of complex interventions: medical research council guidance. BMJ 2015;350:h1258 10.1136/bmj.h1258
    1. Hulscher ME, Laurant MG, Grol RP. Process evaluation on quality improvement interventions. Qual Saf Health Care 2003;12:40–6. 10.1136/qhc.12.1.40
    1. Carroll C, Patterson M, Wood S, et al. . A conceptual framework for implementation fidelity. Implement Sci 2007;2:40 10.1186/1748-5908-2-40
    1. Cassarino M, Robinson K, Quinn R, et al. . Effectiveness of early assessment and intervention by interdisciplinary teams including health and social care professionals in the emergency department: protocol for a systematic review. BMJ Open 2018;8:e023464 10.1136/bmjopen-2018-023464
    1. Gardner G, Gardner A, Middleton S, et al. . Mapping workforce configuration and operational models in Australian emergency departments: a national survey. Aust Health Rev 2018;42:340 10.1071/AH16231
    1. Holmes C, Hollebon D, Scranney A, et al. . Embedding an allied health service in the Nelson hospital emergency department: a retrospective report of a six month pilot project. New Zeal J Physiother 2016;44:17–25. 10.15619/NZJP/44.1.03
    1. Moss JE, Flower CL, Houghton LM, et al. . A multidisciplinary care coordination team improves emergency department discharge planning practice. Med J Aust 2002;177:427–31.
    1. Corbett HM, Lim WK, Davis SJ, et al. . Care coordination in the Emergency Department: improving outcomes for older patients. Aust Health Rev 2005;29:43–50. 10.1071/AH050043
    1. Hasson H. Systematic evaluation of implementation fidelity of complex interventions in health and social care. Implement Sci 2010;5:67 10.1186/1748-5908-5-67
    1. HSE. Emergency Department Task Force. 2015.
    1. Chan AW, Tetzlaff JM, Altman DG, et al. . SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med 2013;158:200 10.7326/0003-4819-158-3-201302050-00583
    1. Möhler R, Köpke S, Meyer G. Criteria for reporting the development and evaluation of complex Interventions in healthcare: revised guideline (CReDECI 2). Trials 2015;16:204 10.1186/s13063-015-0709-y
    1. Dusenbury L, Brannigan R, Falco M, et al. . A review of research on fidelity of implementation: implications for drug abuse prevention in school settings. Health Educ Res 2003;18:237–56. 10.1093/her/18.2.237
    1. Stirman SW, Miller CJ, Toder K, et al. . Development of a framework and coding system for modifications and adaptations of evidence-based interventions. Implement Sci 2013;8:65 10.1186/1748-5908-8-65
    1. Stewart DW, Shamdasani PN. Focus groups: theory and practice. (Accessed 15 May 2019).
    1. Braun V, Clarke V, Terry G. Thematic analysis. Qual Res Clin Heal Psychol 2012;24:95–114.
    1. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006;3:77–101. 10.1191/1478088706qp063oa

Source: PubMed

Спонсоры и соавторы

Заболевания

Медикаментозные вмешательства

Подписаться