Nordic Digital Health Education as an Implementation Tool for Hospital-at-home - Protocol for a Multicenter Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 14
- 试验地点
- 4
- 主要终点
- HaH implementation
研究概览
简要总结
To enhance implementation of Hospital-at-home (HaH) in Scandinavia, the Nordic Digital Health & Education (NorDigHE) project has developed a comprehensive virtual education on HaH for clinical staff. The goal of this clinical trial is to evaluate whether an online education for clinical staff can enhance the implementation of HaH services in hospitals across Denmark, Norway, and Sweden.
The primary outcome of the RCT is HaH implementation measured at organization level, understood as a change in clinical practice by increased HaH activity. Secondary outcomes are HaH knowledge and motivation among clinical staff as well as patient days in hospital, days hospitalized at home, 30-day readmission, and mortality.
Researchers will compare hospitals receiving the NorDigHE education (intervention group) to hospitals continuing treatment as usual (control group) to see if the education leads to greater adoption of HaH and changes in service delivery.
Participants will:
- Complete baseline, 3-month, and 6-month surveys assessing HaH activity, staff knowledge, and motivation.
- Participate in a 12-month follow-up assessment (intervention group only).
- Be invited (patients, staff, and management) to take part in semi-structured interviews to share experiences and preferences related to HaH.
- (For staff in the intervention group) Complete the NorDigHE virtual education program embedded in the WHO Fast-IM.
After the study, the control group will be offered access to the NorDigHE education as a participant retention measure.
详细描述
Background: In response to increasing pressures on healthcare systems due to aging populations, and increasing shortages of clinical staff, increased use of digital service designs has been recommended by most governments in Scandinavian and European countries. Virtually supported Hospital-at-Home (HaH) models, delivering acute hospital services in-home have been shown to be both feasible and beneficial. Nevertheless, implementation and scaling barriers are major challenges. To enhance implementation of HaH in Scandinavia, the Nordic Digital Health & Education (NorDigHE) project has developed a compre-hensive virtual education on HaH for clinical staff. The present study aims to evaluate the implementation impact of the NorDigHE education embedded in the WHO Fast-track Implementation Model (WHO Fast-IM).
Methods and analysis: We use a randomized design and nested qualitative studies to meet the aim. Via open-call, hospitals will be recruited in Denmark, Norway, and Sweden and randomized to either receive the education embedded in the WHO Fast-IM or to continue treatment as usual. The primary outcome of the RCT is HaH implementation measured at organization level, understood as a change in clinical practice by increased HaH activity. Secondary outcomes are HaH knowledge and motivation among clinical staff as well as patient days in hospital, days hospitalized at home, 30-day readmission, and mortality. Data are collected at baseline, after 3, and 6 months. A 12-month maintenance measurement is performed in the intervention group. Post-study, the control group is offered the NorDigHE education as a participant re-tention measure. In addition, the attitudes, experiences, and preferences of HaH among patients, clinical staff, and management are collected via nested semi-structured interviews.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- Single (Outcomes Assessor)
入排标准
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Hospitals with clinical departments treating acutely ill in-patients that have, or are ready to establish, the prerequisites and infrastructure for HaH - regardless of the specific approach, envisioned HaH model, primary sector collaborations, or local sector collaboration agreements and frameworks. Each hospital must have or be ready to establish:
- •a governance structure to organize and oversee HaH-services.
- •an IT-platform capable of managing data from and to HaH patients.
- •a safe communication pathway between HaH-patient and the hospital.
- •clear agreements on types of data to be exchanged between HaH-patient and hospital.
- •agreements on roles, responsibilities, and capacity (incl. possibly primary sector entities).
- •clinical guidelines, standard operating procedures, and action plans to support the HaH work.
排除标准
- •Hospitals that do not have or are not ready to secure relevant pre-requisites listed above (a to f).
结局指标
主要结局
HaH implementation
时间窗: From enrollment until 6 months follow-up measurement
The primary outcome, HaH implementation at the organizational level, is defined as a change in clinical practice, measured by the proportion of eligible patients who receive HaH.
次要结局
- Staff's motivation(From enrollment until 6 months follow-up)
- Staff's knowledge(From enrollment until 6 months follow-up)
- Days hospitalized at home(From enrollment until 6 months follow-up)
- 30-day readmission(From enrollment until 6 months follow-up)
- Mortality(From enrollment until 6 months follow-up)