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dc.contributor.authorGoodman, Claire
dc.contributor.authorGordon, Adam L
dc.contributor.authorMartin , Finbarr
dc.contributor.authorDavies, Susan
dc.contributor.authorIliffe, Steve
dc.contributor.authorBowman, Clive
dc.contributor.authorSchneider, Justine
dc.contributor.authorMeyer, Julienne
dc.contributor.authorVictor, Christina
dc.contributor.authorGage, Heather
dc.contributor.authorGladman, John
dc.contributor.authorDening, Tom
dc.date.accessioned2014-06-17T09:30:38Z
dc.date.available2014-06-17T09:30:38Z
dc.date.issued2014-05-24
dc.identifier.citationGoodman , C , Gordon , A L , Martin , F , Davies , S , Iliffe , S , Bowman , C , Schneider , J , Meyer , J , Victor , C , Gage , H , Gladman , J & Dening , T 2014 , ' Effective health care for older people resident in care homes : The Optimal study protocol for realist review ' , Systematic reviews , vol. 3 , 49 , pp. 7 . https://doi.org/10.1186/2046-4053-3-49
dc.identifier.otherPURE: 7145746
dc.identifier.otherPURE UUID: 82af531e-82cf-4303-8af1-59d9324be95f
dc.identifier.otherScopus: 84906933861
dc.identifier.urihttp://hdl.handle.net/2299/13739
dc.description© 2014 Goodman et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
dc.description.abstractBackground: Care homes in the UK rely on general practice for access to specialist medical and nursing care as well as referral to therapists and secondary care. Service delivery to care homes is highly variable in both quantity and quality. This variability is also evident in the commissioning and organisation of care home-specific services that range from the payment of incentives to general practitioners (GPs) to visit care homes, to the creation of care home specialist teams and outreach services run by geriatricians. No primary studies or systematic reviews have robustly evaluated the impact of these different approaches on organisation and resident-level outcomes. Our aim is to identify factors which may explain the perceived or demonstrated effectiveness of programmes to improve health-related outcomes in older people living in care homes. Methods/Design: A realist review approach will be used to develop a theoretical understanding of what works when, why and in what circumstances. Elements of service models of interest include those that focus on assessment and management of residents’ health, those that use strategies to encourage closer working between visiting health care providers and care home staff, and those that address system-wide issues about access to assessment and treatment. These will include studies on continence, dignity, and speech and language assessment as well as interventions to promote person centred dementia care, improve strength and mobility, and nutrition. The impact of these interventions and their different mechanisms will be considered in relation to five key outcomes: residents’ medication use, use of out of hours’ services, hospital admissions (including use of Accident and Emergency) and length of hospital stay, costs and user satisfaction. An iterative three-stage approach will be undertaken that is stakeholder-driven and optimises the knowledge and networks of the research team. Discussion: This realist review will explore why and for whom different approaches to providing health care to residents in care homes improves access to health care in the five areas of interest. It will inform commissioning decisions and be the basis for further research. This systematic review protocol is registered on the PROSPERO database reference number: CRD42014009112en
dc.language.isoeng
dc.relation.ispartofSystematic reviews
dc.titleEffective health care for older people resident in care homes : The Optimal study protocol for realist reviewen
dc.contributor.institutionCentre for Research in Public Health and Community Care
dc.contributor.institutionDepartment of Adult Nursing and Primary Care
dc.contributor.institutionHealth & Human Sciences Research Institute
dc.contributor.institutionSchool of Health and Social Work
dc.contributor.institutionOlder People's Health and Complex Conditions
dc.contributor.institutionNursing, Midwifery and Social Work
dc.description.statusPeer reviewed
rioxxterms.versionVoR
rioxxterms.versionofrecordhttps://doi.org/10.1186/2046-4053-3-49
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue


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