Evaluation of a Residential In-Reach Program in Regional and Rural Australia

Not Applicable

Not yet recruiting

• Conditions: Aged; Acute Disease

• Registration Number: NCT06901167
• Lead Sponsor: Monash University

Brief Summary

Residential In-Reach (RIR) programs are designed to provide responsive care for residents in residential aged care homes (RACH) with the aim of avoiding unnecessary hospital transfers. The evidence for their clinical and cost-effectiveness and implementation has been established in urban settings, but there is a small amount of low-quality evidence for rural and regional settings. The Grampians Region Health Service Partnership Resi-In-Reach Redesign Committee will be implementing a new RIR program to be offered to all RACHs in the Grampians region, this project aims to evaluate the clinical and cost-effectiveness of this program, and its implementation in the rural and regional setting. A stepped-wedge trial will be conducted so that as the RIR program is gradually rolled-out across the region, outcomes can be compared in the same facilities across time and between different facilities. The primary outcome measure will be presentation to emergency departments and urgent care centres, and data will also be collected on other clinical outcomes and barriers and enablers of implementing the program. It is anticipated that there will be a reduction in hospital presentations, and a range of barriers and enablers unique to the rural and regional setting will emerge.

Detailed Description

Not available

Study Timeline

• Status Verified: 2025-03
• Study First Submitted: 2025-03-04
• Study First Submitted QC: 2025-03-23
• Last Update Submitted: 2025-03-23
• Study First Posted: 2025-03-28
• Last Update Posted: 2025-03-28
• Study Start: 2025-04-01
• Primary Completion: 2026-05-31
• Study Completion: 2026-06-30

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 100

Inclusion Criteria

• Health services that have emergency departments and/or emergency care centres that admit residents from residential aged care homes (RACH)
• RACHs that do not currently have access to RIR programs
• health service staff who have been involved with the set-up and delivery of the RIR program,
• RACH staff who have experience of or accessing the RIR service for residents at least once,
• residents living at a RACH who has experienced receiving medical care from the RIR program and can provide informed consent, or a family member of the resident,
• general practitioners whose case load includes residents from RACHs.

Exclusion Criteria

• RACHs that already have access to a RIR program will be excluded

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Primary Outcome Measures

Name	Time	Method
Rate of presentations from residential aged care homes to emergency departments and emergency care centres	From enrolment to the end of the trial for 14 months	Primary clinical effectiveness outcome; Collection schedule: * Once at the end of the evaluation; * At the level of each residential aged care home presentation to hospital each month Collection approach: Extraction from hospital records and extraction from residential aged care home systems

Secondary Outcome Measures

Name	Time	Method
Location of mortality in hospital	From enrolment to the end of the trial for 14 months	Secondary clinical effectiveness outcome; Collection schedule: * Once at the end of the evaluation; * At the level of each residential aged care home presentation to hospital each month Collection approach: Extraction from hospital records and extraction from residential aged care home systems
Number of barriers to residential-in-reach program implementation	From enrolment to 1 month after the end of the trial, for 15 months	Secondary implementation outcome - collected once via semi-structured interviews with key stakeholders (health service staff, residential aged care home staff).
Number of enablers to residential-in-reach program implementation	From enrolment to 1 month after the end of the trial, for 15 months	Secondary implementation outcome - collected once via semi-structured interviews with key stakeholders (health service staff, residential aged care home staff).
Stakeholder reported feasibility of the residential-in-reach program implementation	From enrolment to 1 month after the end of the trial, for 15 months	Secondary implementation outcome - collected once via semi-structured interviews with key stakeholders (health service staff, residential aged care home staff).
Stakeholder reported acceptability of the residential in-reach program	From enrolment to the end of the trial for 14 months	Secondary implementation outcome - collected via semi-structured interviews with key stakeholders (health service staff, residential aged care home staff, general practitioners, aged care home residents) after occasions of service on a monthly basis.
Stakeholder reported appropriateness of the residential in-reach program	From enrolment to the end of the trial for 14 months	Secondary implementation outcome - collected via semi-structured interviews with key stakeholders (health service staff, residential aged care home staff, general practitioners, aged care home residents) after occasions of service on a monthly basis.
Number of aged care staff who attend education sessions for the use of the residential in-reach program	From enrolment to the end of the trial for 14 months	Secondary implementation outcome - recorded attendance of education sessions for residential aged care home staff for the use of the residential in-reach program.
Number of adaptations made to the residential in-reach program	From enrolment to the end of the trial fo	Secondary implementation outcome - documented adaptations made to the program during the trial period.
Days spent in hospital by aged care home resident	From enrolment to the end of the trial for 14 months	Secondary clinical effectiveness outcome; Collection schedule: * Once at the end of the evaluation; * At the level of each residential aged care home presentation to hospital each month Collection approach: Extraction from hospital records and extraction from residential aged care home systems

Trial Locations

Locations (8)

East Grampians Health Service; 🇦🇺 Ararat, Victoria, Australia

Grampians Health; 🇦🇺 Ballarat, Victoria, Australia

Beaufort and Skipton Health Service; 🇦🇺 Beaufort, Victoria, Australia

Central Highlands Rural Health; 🇦🇺 Daylesford, Victoria, Australia

Maryborough District Health Service; 🇦🇺 Maryborough, Victoria, Australia

West Wimmera Health Service; 🇦🇺 Nhill, Victoria, Australia

East Wimmera Health Service; 🇦🇺 St Arnaud, Victoria, Australia

Rural Northwest Health; 🇦🇺 Warracknabeal, Victoria, Australia