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A randomised controlled trial exploring the impact of a dedicated health and social care professionals team in the emergency department on the quality, safety, clinical and cost-effectiveness of care for older adults: a study protocol

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dc.contributor.author Cassarino, Marica
dc.contributor.author Robinson, Katie
dc.contributor.author O’Shaughnessy, Íde
dc.contributor.author Smalle, Eimear
dc.contributor.author White, Stephen
dc.contributor.author Devlin, Collette
dc.contributor.author Quinn, Rosie
dc.contributor.author Trépel, Dominic André
dc.contributor.author Boland, Fiona
dc.contributor.author Ward, Marie E.
dc.contributor.author McNamara, Rosa
dc.contributor.author O’Connor, Margaret
dc.contributor.author McCarthy, Gerard
dc.contributor.author Ryan, Damien
dc.contributor.author Galvin, Rose
dc.date.accessioned 2019-10-29T16:24:27Z
dc.date.available 2019-10-29T16:24:27Z
dc.date.issued 2019
dc.identifier.uri http://hdl.handle.net/10344/8188
dc.description peer-reviewed en_US
dc.description.abstract Background: Older people are frequent emergency department (ED) users who present with complex issues that are linked to poorer health outcomes following the index visit, often have increased ED length of stay, and tend to have raised healthcare costs. Encouraging evidence suggests that ED teams involving health and social care professionals (HSCPs) can contribute to enhanced patient flow and an improved patient experience by improving care decision-making and thus promoting timely and effective care. However, the evidence supporting the impact of HSCP teams assessing and intervening with older adults in the ED is limited and identifies important methodological limitations, highlighting the need for more robust and comprehensive investigations of this model of care. This study aims to evaluate the impact of a dedicated ED-based HSCP team on the quality, safety, and clinical- and cost-effectiveness of care of older adults when compared with usual care. Methods: The study is a single-site randomised controlled trial whereby patients aged ≥65 years who present to the ED of a large Irish hospital will be randomised to the experimental group (ED-based HSCP assessment and intervention) or the control group (usual ED care). The recruitment target is 320 participants. The HSCP team will provide a comprehensive functional assessment as well as interventions to promote a safe discharge for the patient. The primary outcome is ED length of stay (from arrival to discharge). Secondary outcomes include: rates of hospital admissions from the ED, ED re-visits, unplanned hospital admissions and healthcare utilisation at 30 days, and 4 and 6 months of follow-up; patient functional status and quality of life (at baseline and follow up); patient satisfaction; cost-effectiveness in terms of costs associated with ED-based HSCP compared with usual care; and perceptions on implementation by ED staff members Discussion: This is the first randomised controlled trial testing the impact of HSCPs working in teams in the ED on the quality, safety, and clinical- and cost-effectiveness of care for older patients. The findings of this study will provide important information on the effectiveness of this model of care for future implementation en_US
dc.language.iso eng en_US
dc.publisher BMC en_US
dc.relation.ispartofseries Trails;20,591
dc.subject Emergency department en_US
dc.subject Health and social care professional en_US
dc.subject Team care en_US
dc.subject Older patients en_US
dc.subject effectiveness en_US
dc.title A randomised controlled trial exploring the impact of a dedicated health and social care professionals team in the emergency department on the quality, safety, clinical and cost-effectiveness of care for older adults: a study protocol en_US
dc.type info:eu-repo/semantics/article en_US
dc.type.supercollection all_ul_research en_US
dc.type.supercollection ul_published_reviewed en_US
dc.identifier.doi 10.1186/s13063-019-3697-5
dc.contributor.sponsor HRB en_US
dc.rights.accessrights info:eu-repo/semantics/openAccess en_US


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