S6.2 Experiences from how interdisciplinary network initiatives enhance care home research
Chair: Kjell Halvorsen
Introduction: Due to aging populations, societies need to conduct high quality research within elderly care and nursing home medicine. One approach is to establish interdisciplinary networks of researchers and health colleagues with a genuine interest for the topic. Objective: The authors will present how collaborative networks can enhance research and quality improvement projects in care homes. Presenters: The symposium will comprise four presentations with speakers from three countries in the following order:
S6.2.1 The University Network for the Care Sector in the Netherlands (UNC-ZH) Wilco Achterberg Leiden University
UNC-ZH is an active collaboration between the department of public health and primary care of the Leiden University Medical Center and nine nursing home organisations. The closely linked structure between the university and practice aim to improve quality of care by building and sharing knowledge. This collaboration has establish 10 PhD projects on relevant research topics for daily nursing home care. It facilitates research in an environment that is unexperienced in doing studies and complying to research methodology. We will give examples of studies that have been performed: a randomized clinical trial on the use of Cranberry capsules for UTI (n=1000), a clustered randomized trial on a fear of falling intervention in hip fracture patient, and an action research on improving timely palliative care.
S6.2.2 Enabling Research in Care Homes: strategies to build a national infrastructure and collaboration for research with and in care homes
Claire Goodman1, Adam Gordon2
1University of Hertfordshire, UK, 2University of Nottingham, UK
In England commercial companies and not for profit organisations are the main providers of long term care for older people. Most residents are in their mid-eighties, with multiple morbidities and a limited life expectancy. The increase in care home research has highlighted the need for national co-ordination and collaboration to improve the efficacy and impact of research in these settings. In 2012 an online resource (ENRICH) was established to build a network of “research-ready“ care homes. Currently, it holds a database of research engaged care homes, provides news of current studies, resource materials, expert advice and guidelines on undertaking research in care homes. In November 2017, 80 national delegates met to establish how learning from local innovation could be the platform for national collaboration in care home research. It reviewed progress, areas of shared interest, possible duplication and set priorities for future work and funding. ENRICH has recruited 1097 care homes. Benefits include access to staff education, improved care, positive feedback from regulators, increasing recruitment to research, and the opportunity for staff to voice their opinions, concerns and ideas for improving residents’ care. The national consensus meeting has established a new collaboration that demonstrates innovation in research methodology. Establishing national networks enables care home staff and researchers to increase the scale and pace of research and access to best evidence for what is effective care for this population.
S6.2.3 Research and Clinical Quality Improvement in Parallel: lessons from the PEACH study
University of Nottingham, UK
The Proactive Healthcare for Older People in Care Homes (PEACH) study is exploring whether Quality Improvement Collaboratives (QICs) can be applied to deliver healthcare to UK care home residents. This is a setting where complex collaborations between multiple health and social care providers with differing priorities challenge relational working around mutually agreed priorities in patient care. QICs are organised by PEACH researchers, who provide logistical support and quality improvement coaching, whilst concurrently keeping detailed observations and field notes on interactions between collaborative members and how they change practice as a consequence of their interactions. The study has developed an automated algorithm to capture care home admissions to acute hospitals to retrieve admissions, readmissions and length of stay data to support time series analysis (primary study outcomes). The study team are also using these to generate real-time care dashboards co-designed by the collaboratives. A test bed of 174 care home residents are enabling impacts on health-related quality of life to be understood using EQ-5D and R-outcomes. Emerging findings from the collaboratives are establishing contextual factors which influence how the collaboratives work to achieve the desired outcomes of modifications to care practices and improved care. Changes in practice which have been seen are being celebrated and shared by the clinical teams at the same time as they are being understood by the researchers. PEACH is an example of quality improvement and research conducted in parallel, incorporating robust methodological approaches including realist synthesis, realist evaluation and interrupted time-series analysis of service use data.
S6.2.4 Norwegian University Network for Elderly and Nursing Home Care between Bergen, Oslo; Trondheim, and Tromsø (ELDERLY-BOTT)
Bettina Husebø1, Marit Kirkevold2, Tove Rosstad3, Kjell H. Halvorsen4
1University of Bergen, Norway, 2University of Oslo, Noway, 3University of Trondheim, Norway, 4The Arctic University of Norway.
The proportion of older people with complex diseases will increase considerably during the next centuries. In their last years of life, most people require optimal treatment to manage medical challenges and end-of-life care. Despite evidence-based knowledge is available, interdisciplinary education of students from different faculties (e.g. medicine, nursing, pharmacy, law) is a prerequisite for implementation and research in elderly care. Development of a university network between Bergen, Oslo, Trondheim, and Tromsø (BOTT) aim to support interdisciplinary education, research, and collaboration between universities, university colleges, and primary care. Elderly-BOTT provides innovative activities to contribute actively: a) Updated website, regularly newsletters, book-project, and mobil application; b) interdisciplinary education and lectures; c) contributions to guideline development for diagnostic and treatment in dementia, including end-of-life care; d) national elderly campaign “Live the whole life”. Universities have to be engaged in innovative development to make groundbreaking changes and recruitment in elderly care. Conclusion: Attendees to the symposium will learn about network initiatives and get insight in how interdisciplinary network initiatives can benefit research within the field of elderly and nursing home medicine.