Baxter, Ruth, Murray, Jenni, Cockayne, Sarah orcid.org/0000-0002-1288-5497 et al. (8 more authors) (2022) Improving the safety and experience of transitions from hospital to home:a cluster randomised controlled feasibility trial of the Your Care Needs You Intervention versus usual care. Pilot and Feasibility Studies. 222. ISSN 2055-5784
Abstract
Background: The ‘Your Care Needs You’ (YCNY) intervention aims to increase the safety and experience of transitions for older people through greater patient involvement during the hospital stay. Methods: A cluster-randomised controlled feasibility trial was conducted on NHS inpatient wards (clusters) where ≥40% were routinely ≥75 years. Wards were randomised to YCNY or usual care using an unequal allocation ratio (3:2). We aimed to recruit up to 20 patients per ward. Follow-up included routine data collection and questionnaires at 5, 30 and 90-days post-discharge. Eligible patients were ≥75, discharged home, stayed overnight on participating wards, and could read and understand English. The trial assessed the feasibility of delivering YCNY and the trial methodology through recruitment rates, outcome completion rates, and a qualitative evaluation. The accuracy of using routinely coded data for the primary outcome in the definitive trial was assessed by extracting discharge information for up to ten non-individual consenting patients per ward. Results: Ten wards were randomised (6 intervention, 4 control). One ward withdrew and two wards were unable to deliver the intervention. 721 patients were successfully screened, and 161 were recruited (95 intervention, 66 control). The patient post-discharge attrition rate was 17.4% (n=28). Primary outcome data were gathered for 91.9% of participants with 75.2% and 59.0% providing secondary outcome data at 5 and 30 days post discharge respectively. Item completion within questionnaires was generally high. Post-discharge follow-up was terminated early due to the COVID-19 pandemic affecting 90 day response rates (16.8%). Data from 88 non-individual consenting patients identified an error rate of 15% when using routinely coded data for the primary outcome. No unexpected serious adverse events were identified. Most patients viewed YCNY favourably. Staff agreed with it in principle, but ward pressures and organisational contexts hampered implementation. There was a need to sustain engagement, provide clarity on roles and responsibilities, and account for fluctuations in patients’ health, capacity, and preferences. Conclusions: If implementation challenges can be overcome, YCNY represents a step towards involving older people as partners in their care to improve the safety and experience of their transitions from hospital to home. Trial registration: ISRCTN: 51154948
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © The Author(s) 2022. |
Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Sciences (York) > Health Sciences (York) The University of York > Faculty of Social Sciences (York) > Centre for Health Economics (York) |
Funding Information: | Funder Grant number NIHR-CCF RP-PG-1214-20017 |
Depositing User: | Pure (York) |
Date Deposited: | 20 Oct 2022 15:40 |
Last Modified: | 16 Oct 2024 18:48 |
Published Version: | https://doi.org/10.1186/s40814-022-01180-3 |
Status: | Published |
Refereed: | Yes |
Identification Number: | 10.1186/s40814-022-01180-3 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:192389 |
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Description: Improving the safety and experience of transitions from hospital to home: a cluster randomised controlled feasibility trial of the 'Your Care Needs You' intervention versus usual care
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