Evidence map›Paper›PMID 31615573›Full record

ArticleTrials2019

A randomised controlled trial exploring the impact of a dedicated health and social care professionals team in the emergency department on the quality, safety, clinical and cost-effectiveness of care for older adults: a study protocol.

Marica Cassarino, Katie Robinson, Íde O'Shaughnessy, Eimear Smalle, Stephen White, Collette Devlin, Rosie Quinn, Dominic Trépel, Fiona Boland, Marie E Ward and 5 more

Registry-linked trialAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in Trials, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03739515 (A Pilot Randomised Controlled Trial Exploring the Impact of a Dedicated Health and Social Care Professionals), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03739515 naunknown statusnot on this map

A Pilot Randomised Controlled Trial Exploring the Impact of a Dedicated Health and Social Care Professionals (HSCP) Team in the Emergency Department on the Quality, Safety and Cost-effectiveness of Care for Older Adults

TypeinterventionalSponsorUniversity of LimerickRan2018 to 2019Enrolled354ConditionsED-based Allied Health ServicesArmsHSCP intervention, ED routine care
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Trial
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Marica CassarinoSchool of Allied Health, Faculty of Education and Health Sciences, Health Research Institute, Ageing Research Centre, University of Limerick, Limerick, Ireland. marica.cassarino@ul.ie.ORCID http://orcid.org/0000-0002-1624-921X
Katie RobinsonSchool of Allied Health, Faculty of Education and Health Sciences, Health Research Institute, Ageing Research Centre, University of Limerick, Limerick, Ireland.
Íde O'ShaughnessyEmergency Department, University Hospital Limerick, Limerick, Ireland.
Eimear SmalleEmergency Department, University Hospital Limerick, Limerick, Ireland.
Stephen WhiteEmergency Department, University Hospital Limerick, Limerick, Ireland.
Collette DevlinEmergency Department, University Hospital Limerick, Limerick, Ireland.
Rosie QuinnEmergency Department, Our Lady of Lourdes Hospital, Drogheda, Ireland.
Dominic TrépelSchool of Medicine, Trinity College Dublin, Dublin, Ireland.
Fiona BolandHRB Centre for Primary Care Research, Royal College of Surgeons in Ireland, Dublin, Ireland.
Marie E WardSchool of Psychology, Trinity College, The University of Dublin, Dublin, Ireland.
Rosa McNamaraEmergency Department, St. Vincent University Hospital, Dublin, Ireland.
Margaret O'ConnorGraduate Entry Medical School, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland.
Gerard McCarthyEmergency Department, Cork University Hospital, Cork, Ireland.
Damien RyanGraduate Entry Medical School, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland.
Rose GalvinSchool of Allied Health, Faculty of Education and Health Sciences, Health Research Institute, Ageing Research Centre, University of Limerick, Limerick, Ireland.

Funding

Health Research Board of Ireland RCQPS-2017-2
6 · The paper itself

Abstract

backgroundOlder people are frequent emergency department (ED) users who present with complex issues that are linked to poorer health outcomes following the index visit, often have increased ED length of stay, and tend to have raised healthcare costs. Encouraging evidence suggests that ED teams involving health and social care professionals (HSCPs) can contribute to enhanced patient flow and an improved patient experience by improving care decision-making and thus promoting timely and effective care. However, the evidence supporting the impact of HSCP teams assessing and intervening with older adults in the ED is limited and identifies important methodological limitations, highlighting the need for more robust and comprehensive investigations of this model of care. This study aims to evaluate the impact of a dedicated ED-based HSCP team on the quality, safety, and clinical- and cost-effectiveness of care of older adults when compared with usual care.

methodsThe study is a single-site randomised controlled trial whereby patients aged ≥65 years who present to the ED of a large Irish hospital will be randomised to the experimental group (ED-based HSCP assessment and intervention) or the control group (usual ED care). The recruitment target is 320 participants. The HSCP team will provide a comprehensive functional assessment as well as interventions to promote a safe discharge for the patient. The primary outcome is ED length of stay (from arrival to discharge). Secondary outcomes include: rates of hospital admissions from the ED, ED re-visits, unplanned hospital admissions and healthcare utilisation at 30 days, and 4 and 6 months of follow-up; patient functional status and quality of life (at baseline and follow-up); patient satisfaction; cost-effectiveness in terms of costs associated with ED-based HSCP compared with usual care; and perceptions on implementation by ED staff members. DISCUSSION: This is the first randomised controlled trial testing the impact of HSCPs working in teams in the ED on the quality, safety, and clinical- and cost-effectiveness of care for older patients. The findings of this study will provide important information on the effectiveness of this model of care for future implementation.

trial registrationClinicalTrials.gov, NCT03739515 . Registered on 12 November 2018.

Indexed as

Social WorkersAgedAge FactorsCooperative BehaviorCost-Benefit AnalysisEmergency Service, HospitalFemaleGeriatric AssessmentHospital CostsHumansInterdisciplinary CommunicationIrelandMaleOccupational TherapistsPatient Care TeamPatient-Centered CareEffectivenessEmergency departmentHealth and social care professionalOlder patientsTeam care

Identifiers

PMID31615573
PMCPMC6792257

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.