A structure, process and outcome evaluation of the Geriatric Emergency Department Intervention model of care: a study protocol

BMC Geriatrics

Study Protocol

Kim-Huong Nguyen¹  Amanda Glenwright²  Julia Crilly³  Andrea Taylor⁴  Elizabeth Marsden⁴  Adrian Barnett⁵  Marianne Wallis⁶  Marc Broadbent⁶  Colleen Johnston⁶  Alison Craswell⁶ 

[1] Center for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Logan, Australia;Central Queensland, Wide Bay, Sunshine Coast PHN, Ground Floor, Mayfield House, 29 The Esplanade, 4558, Maroochydore, QLD, Australia;Menzies Health Institute Queensland, Griffith University, Parklands Drive, 4215, Parkwood, QLD, Australia;Department of Emergency Medicine, Gold Coast Health, 1 Hospital Blvd, 4215, Southport, QLD, Australia;Nambour Emergency Department, Sunshine Coast and Hospital Health Service, Hospital Rd, 4560, Nambour, QLD, Australia;School of Nursing, Midwifery and Paramedicine, University of Sunshine Coast, 90 Sippy Downs Drive, 4556, Sippy Downs, QLD, Australia;Queensland University of Technology, 4059, Brisbane, QLD, Australia;School of Nursing, Midwifery and Paramedicine, University of Sunshine Coast, 90 Sippy Downs Drive, 4556, Sippy Downs, QLD, Australia;

关键词: Geriatric;    Emergency medical services;    Nurses’ practice patterns;    Hospital;    Homes for the aged;    Delivery of health care;    Protocol;    Outcomes;    Evaluation;    Pragmatic paradigm;   

DOI  :  10.1186/s12877-017-0462-z

 received in 2016-12-20, accepted in 2017-03-10,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundEmergency departments are chaotic environments in which complex, frail older persons living in the community and residential aged care facilities are sometimes subjected to prolonged emergency department lengths of stay, excessive tests and iatrogenic complications. Given the ageing population, the importance of providing appropriate, quality health care in the emergency department for this cohort is paramount. One possible solution, a nurse-led, physician-championed, emergency department gerontological intervention team, which provides frontload assessment, early collateral communication and appropriate discharge planning, has been developed. The aim of this Geriatric Emergency Department Intervention is to maximise the quality of care for this vulnerable cohort in a cost effective manner.MethodsThe Geriatric Emergency Department Intervention research project consists of three interrelated studies within a program evaluation design. The research comprises of a structure, process and outcome framework to ascertain the overall utility of such a program. The first study is a pre-post comparison of the Geriatric Emergency Department Intervention in the emergency department, comparing the patient-level outcomes before and after service introduction using a quasi-experimental design with historical controls. The second study is a descriptive qualitative study of the structures and processes required for the operation of the Geriatric Emergency Department Intervention and clinician and patient satisfaction with service models. The third study is an economic evaluation of the Geriatric Emergency Department Intervention model of care.DiscussionThere is a paucity of evidence in the literature to support the implementation of nurse-led teams in emergency departments designed to target frail older persons living in the community and residential aged care facilities. This is despite the high economic and patient morbidity and mortality experienced in these vulnerable cohorts. This research project will provide guidance related to the optimal structures and processes required to implement the model of care and the associated cost related outcomes.Trial registrationAustralian New Zealand Clinical Trials Registration Number is 12615001157561. Date of registration 29 October 2015.

【 授权许可】

CC BY   
© The Author(s). 2017