The Australian Government Productivity Commission Report on Government Services 2018 reports a 31% increase in admissions to aged care services in the last decade and today more than 200,000 Australians call a residential aged care (RAC) facility home. Many of these residents are frail with escalating comorbidities where the priority for medical care is management rather than cure. However, this group are frequent users of hospital services, with admissions being stressful, costly and often unnecessary or preventable.
To address this, and promote better resident and health service outcomes, a number of initiatives have been developed and implemented in the important area of hospital avoidance for RAC home residents. There is a need to expand the evidence base for these programs and approaches. The Early Detection of Deterioration in Elderly residents (EDDIE+) project is funded by the Medical Research Future Fund Keeping Australians Out of Hospital initiative (GNT1177501), running from 2019-2022. This study will use a stepped-wedge cluster randomised trial design to evaluate a facility-driven hospital avoidance program in twelve Bolton Clarke RAC homes in 2020-2021. This program comprises four core elements that aim to support systems, process and staff behaviour change for improved resident outcomes. This program will be based on the EDDIE program, which was successfully piloted in 2 RAC homes by members of the investigator team. A rigorous program evaluation will increase understanding of the process and impact outcomes, including barriers and facilitators to implementation. Evaluation will also produce evidence on the cost-consequences of the program and the outcomes for residents and health services. This new knowledge will be used to inform and support the future allocation of resources for a range of valuable hospital avoidance programs in this setting.
Read more about this study here.