BHiRCH Pilot cluster randomised trial
Research type
Research Study
Full title
Pilot cluster randomised trial of an evidence based intervention to reduce avoidable hospital admissions in residents in care homes (the Better Health in Residents in Care Homes study)
IRAS ID
220121
Contact name
Elizabeth Sampson
Contact email
Sponsor organisation
University Colle London
Clinicaltrials.gov Identifier
Z6364106/2017/04/58, UCL data protection
Duration of Study in the UK
1 years, 4 months, 1 days
Research summary
Early detection and intervention for ill health in residents in care homes with nursing is problematic. People living in care homes can be admitted to hospital for conditions which, if noticed and treated earlier, could be managed in the care home.
The Better Health in Residents in Care Homes (BHiRCH) programme aims to reduce rates of avoidable hospital admissions from care homes (with nursing) for respiratory infections, urinary tract infections, dehydration and acute exacerbation of chronic heart failure by ensuring early detection and early intervention. This has the potential to prevent an emergency presentation to hospital. This project is focused on these four conditions which are responsible for a large proportion of unplanned hospitalisations.Our Programme Development Grant identified multi-component interventions which, when tested in US nursing homes, showed promise in reducing avoidable admissions. The BHiRCH programme comprises the following components:
1.Early Warning Tool (Stop and Watch Early Warning Tool).
2.Care Pathway (clinical guidance and decision support system).
3.Structured method for communicating with primary care.
4.Implementation support.The research will take place in 14 care homes across Yorkshire and London over a 16-month period. Nursing homes will be randomly allocated to 7 intervention or 7 “usual care” distributed between London and Yorkshire. Two nurses within each home will become Practice Development Champions who will be trained to implement the intervention, and these nurses will be supported by a Practice Development Support Group. Number of avoidable hospital admission will be recorded along with other data collected from staff, residents and care partners through questionnaires. The aim of the research is to identify whether a further definitive study is warranted.
REC name
London - Queen Square Research Ethics Committee
REC reference
17/LO/1542
Date of REC Opinion
18 Oct 2017
REC opinion
Further Information Favourable Opinion