A randomised controlled trial evaluating the impact of a new Supported Discharge Team with patients being discharged from hospital in the Waikato region who have recently suffered an acute illness or injury.
- Conditions
- Acute illness or injury requiring hospitalisation or ED attendancePhysical Medicine / Rehabilitation - Other physical medicine / rehabilitationPublic Health - Health service research
- Registration Number
- ACTRN12611000982910
- Lead Sponsor
- Waikato District Health Board.
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Completed
- Sex
- All
- Target Recruitment
- 300
1. The client is over 65 years (or close in age and interest) and lives within the catchment area Waikato DHB; 2. The client does not require acute hospital based treatment; 3. The client consents to being treated at home by the team, is aware of and is in agreement with the objectives set by the referring inter-disciplinary team; 4. Following assessment, the client is considered to have potential for partial or complete recovery with suitable home rehabilitation within six weeks; 5. The client is able to stand and transfer with one person (with or without the help of a resident carer); 6. The client's home is judged to be safe for the client in addition to the visiting staff and; 7. The client has had a recent acute illness or injury or is at a borderline level of function with an associated reduction in personal (PADL) and / or extended (EADL) activities of daily living and who without input from the team is: I. likely to fail to recuperate full potential of functional recovery; II. or is likely to fail to manage satisfactorily at home despite conventional community support and therefore would be at risk of hospital re-admission or institutionalisation.
1.Clients who have been discharged from acute hospital care for more than 48 hours
2.Clients without clinical need, only social need, e.g. clients needing support during usual caregivers admission to hospital
3.Where the home environment is not conducive to achieving the rehabilitation outcomes for the client
4.Where the clients primary rehabilitation intervention is provided in an outpatient setting
5.Clients with progressive or deteriorating conditions where partial or full recovery cannot be reasonably expected within six weeks (e.g. Palliative care):
6.The client is eligible for assessment, treatment and rehabilitation funded under the injury Prevention, Rehabilitation and Compensation Act (2001)
7.The clients service needs are covered under another service specification or funding stream
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method A Decrease in hospital length of stay and in the number of ED visits.<br>Information will be collected on patient health service usage through centralised databases as well as direct information obtained through patient/family interview on satisfaction with services.[ Six months after randomisation ];A decrease in Aged Residential Care admissions and Home Care usage.<br>Information will be collected on patient health service usage through centralised databases as well as direct information obtained through patient/family interview on satisfaction with services. Functional status will be measured using the interRAI contact assessment at baseline and twelve months, which will also include demographic data.[At 6months after randomisation ]
- Secondary Outcome Measures
Name Time Method Gathering information on Patient and practitioner perceptions of the START service.<br>This outcome will be assessed using a process evaluation method. The process evaluation typically has four steps and will answer questions about what happened in the implementation of the START. These steps are:<br>1. Development of the programme Logic<br>2. Examine programme Implementation<br>3. Examine programme dosage<br>4. Examine programme fidelity[At 6 months post randomisation.];To identify and analysis the cost of START from a health perspective and a patient perspective. <br>This question will be answered by cost data collection from the DHB, a START staff log record and by interviewing patients[At 6 months post randomisation.]