Evidence map›Paper›PMID 41688110›Full record

ArticleBMJ open2026

Implementing a bundle of interventions to support older adults transitioning from hospital to residential aged care: a protocol for the process evaluation of the OPTIMAL stepped wedge cluster randomised controlled trial.

Rangika L Fernando, Maria Crotty, Maria C Inacio, Ishita Batta, Alice Bourke, John Forward, Chloe Furst, Craig Whitehead, Sandra Shaw, Luke Shepperd and 1 more

Abstract readClinical Trial Protocol
In one paragraph

Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. 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

11 authors.

Rangika L FernandoFlinders University, College of Medicine and Public Health, Flinders Health and Medical Research Institute, Adelaide, South Australia, Australia rangika.fernando@flinders.edu.au.ORCID http://orcid.org/0000-0002-2840-204X
Maria CrottyFlinders University, College of Medicine and Public Health, Flinders Health and Medical Research Institute, Adelaide, South Australia, Australia.ORCID http://orcid.org/0000-0002-2996-5135
Maria C InacioRegistry of Senior Australians (ROSA) Research Centre, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.ORCID http://orcid.org/0000-0001-8261-2665
Ishita BattaRoyal Adelaide Hospital, Central Adelaide Local Health Network, SA Health, Adelaide, South Australia, Australia.
Alice BourkeAged Care, Rehabilitation and Palliative Care, Northern Adelaide Local Health Network, Modbury, South Australia, Australia.
John ForwardAged Care, Rehabilitation and Palliative Care, Northern Adelaide Local Health Network, Modbury, South Australia, Australia.
Chloe FurstRoyal Adelaide Hospital, Central Adelaide Local Health Network, SA Health, Adelaide, South Australia, Australia.
Craig WhiteheadFlinders University, College of Medicine and Public Health, Flinders Health and Medical Research Institute, Adelaide, South Australia, Australia.
Sandra ShawRehabilitation, Aged Care and Palliative Care, Southern Adelaide Local Health Network, SA Health, Bedford Park, South Australia, Australia.
Luke ShepperdRoyal Adelaide Hospital, Central Adelaide Local Health Network, SA Health, Adelaide, South Australia, Australia.
Gillian HarveyFlinders University, College of Nursing and Health Sciences, Caring Futures Institute, Adelaide, South Australia, Australia.ORCID http://orcid.org/0000-0003-0937-7819

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe Optimising older People's Transition from acute care Into residential aged care through Multidisciplinary Assessment and Liaison (OPTIMAL) trial is a multisite hybrid type II stepped wedge randomised controlled trial with an embedded process evaluation that aims to evaluate the effectiveness of implementing a bundle of evidence-based interventions to provide systematic support to older adults being discharged from hospital to residential aged care (RAC) homes for the first time. The trial is based on evidence from models of care used internationally to improve the quality of care transitions and addresses a need to provide evidence of transferability and effectiveness of these models in the Australian context. The embedded process evaluation will assess the acceptability, appropriateness, feasibility, adoption and fidelity of the OPTIMAL intervention, as well as the mechanisms of impact. METHODS AND ANALYSIS: The OPTIMAL trial will be implemented across the three metropolitan local health networks (LHNs) in South Australia. The process evaluation will be conducted in parallel with the main trial and is theoretically informed by the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) implementation framework, which theorises that the implementation success of OPTIMAL is determined by the facilitation of the intervention with the intended recipients in their inner and outer contextual setting. The process evaluation will employ a mixed methods approach. Qualitative and quantitative data will be collected through baseline context mapping of LHNs, interviews with key LHN and RAC stakeholders, online survey of clinical teams, fortnightly check-in forms, and activity logs and field notes maintained by the nurse facilitator in each LHN. Data will be mapped and reported based on the i-PARIHS framework. ETHICS AND DISSEMINATION: Ethical approval for the OPTIMAL trial was obtained from the Southern Adelaide Clinical Human Research Ethics Committee (approval 2023/HRE00111), and the relevant governance approvals were obtained for each participating LHN. Ethical approval includes a waiver of the requirement for consent for routinely collected patient data. Study findings will be disseminated via journal publications, presentations at conferences, stakeholder discussions, consumer forums and advocacy to key decision makers to support knowledge translation. TRIAL REGISTRATION NUMBER: Australia New Zealand Clinical Trial Registry, ACTRN12624001008516, registered 20 August 2024.

Indexed as

Homes for the AgedAgedHumansMulticenter Studies as TopicPatient DischargeProcess Assessment, Health CareRandomized Controlled Trials as TopicSouth AustraliaAgedGERIATRIC MEDICINEHealth Services for the AgedImplementation ScienceRandomized Controlled Trial

Identifiers

PMID41688110
PMCPMC12911669

What OpenQuestion holds

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Registered trials

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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.