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首页> 外文期刊>Trials >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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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

机译：一项随机对照试验，探讨急诊部门专门的健康和社会护理专业人员团队对老年人护理质量，安全性，临床和成本效益的影响：研究方案

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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. 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. 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. ClinicalTrials.gov, NCT03739515 . Registered on 12 November 2018.
机译：老年人是急诊科（ED）的频繁使用者，他们在索引访问后出现复杂的问题，这些问题与较差的健康结果相关，通常会增加ED的住院时间，并往往会增加医疗费用。令人鼓舞的证据表明，由健康和社会护理专业人员（HSCP）参与的ED团队可以通过改善护理决策制定并从而促进及时有效的护理，为增加患者流量和改善患者体验做出贡献。但是，支持HSCP团队评估和干预急诊中老年人的影响的证据是有限的，并且指出了重要的方法学局限性，这突出表明需要对这种护理模式进行更强大，更全面的研究。这项研究旨在评估与常规护理相比，基于ED的HSCP专业团队对老年人护理的质量，安全性以及临床和成本效益的影响。该研究是一项单地点随机对照试验，根据该试验，≥65岁的就诊于爱尔兰一家大型医院急诊室的患者将被随机分为实验组（基于ED的HSCP评估和干预）或对照组（通常为ED）关心）。招募目标是320名参与者。 HSCP团队将提供全面的功能评估以及干预措施，以促进患者安全出院。主要结果是ED的住院时间（从到达到出院）。次要结果包括：急诊部住院率，急诊部再次就诊，计划外住院和30天以及随访4个月和6个月的医疗保健利用率;患者的功能状态和生活质量（基线和随访）;患者满意度;与常规护理相比，与基于ED的HSCP相关的成本方面的成本效益;以及ED工作人员对实施的看法。这是第一项随机对照试验，测试了HSCP在急诊室团队中工作对老年患者的护理质量，安全性以及临床和成本效益的影响。这项研究的结果将提供有关这种护理模式对将来实施的有效性的重要信息。 ClinicalTrials.gov，NCT03739515。 2018年11月12日注册。

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