Childrens Hospital at Home: Safety Equity (CH@HSE)
Research type
Research Study
Full title
A Realist Evaluation of the Provision of Safety Equity in Hospital at Home for Children when Managing Clinical Deterioration.
IRAS ID
350330
Contact name
Beth Fylan
Contact email
Sponsor organisation
University of bradford
Duration of Study in the UK
0 years, 9 months, 14 days
Research summary
BACKGROUND
Hospital at Home (HaH) also known as Virtual Ward (VW) is a developing model of healthcare that relocates the delivery of care for a variety of acute illness out of the hospital and into patients homes. Ensuring the safety of this evolving model in paediatric care is vital as children are a vulnerable patient group and even low levels of error can impact a child’s health and future wellbeing (Kalisch et al. 2009). In HaH these inherent vulnerabilities are transferred from the hospital environment and the supervision of clinicians, into the child's home environment where parent/carers experience an increased responsibility for providing safe care.
Some people receiving health care are at a higher risk of harm than others due to their demographics and social determinants of health. In this study this phenomenon is referred to as 'safety inequity' and the efforts of services to provide equally safe outcomes for all as 'safety equity'.
AIM
The aim of this study is to explore the mechanisms that underpin the provision of safety equity when managing deterioration, in children cared for by HaH, and contexts that support or constrain them.
METHODS
Realist evaluation which is concerned with understanding for whom and in what circumstances complex interventions work and involves building, testing and refining the theories of how the intervention is supposed to work provides an overall framework for this study. Routine practice observations, realist interviews, document review, service admission/ readmission data review will be undertaken in hospital at home for children services in two localities.The findings of the research will be used to develop actionable frameworks and/or guidelines to inform service commissioners and policy makers of best practice in safe outcomes in Hospital at Home for Children. An amendment to this study at a later date will be made to incorporate this work package.
REC name
London - Surrey Research Ethics Committee
REC reference
25/LO/0640
Date of REC Opinion
5 Sep 2025
REC opinion
Favourable Opinion