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dc.contributor.authorVoss, Sarah
dc.contributor.authorBlack, Sarah
dc.contributor.authorBrandling, Janet
dc.contributor.authorBuswell, Marina
dc.contributor.authorCheston, Richard
dc.contributor.authorCullum, Sarah
dc.contributor.authorKirby, Kim
dc.contributor.authorPurdy, Sarah
dc.contributor.authorSolway, Chris
dc.contributor.authorTaylor, Hazel
dc.contributor.authorBenger, Jonathan
dc.date.accessioned2017-06-01T15:46:32Z
dc.date.available2017-06-01T15:46:32Z
dc.date.issued2017-04-01
dc.identifier.citationVoss , S , Black , S , Brandling , J , Buswell , M , Cheston , R , Cullum , S , Kirby , K , Purdy , S , Solway , C , Taylor , H & Benger , J 2017 , ' Home or hospital for people with dementia and one or more other multimorbidities: What is the potential to reduce avoidable emergency admissions? The HOMEWARD Project Protocol ' , BMJ Open , vol. 7 , no. 4 . https://doi.org/10.1136/bmjopen-2017- 016651
dc.identifier.issn2044-6055
dc.identifier.otherPURE: 11631550
dc.identifier.otherPURE UUID: fad5dd17-0451-48d3-be35-e107edead4c7
dc.identifier.otherScopus: 85017091591
dc.identifier.urihttp://hdl.handle.net/2299/18271
dc.descriptionThis is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/. Voss S, et al. BMJ Open 2017;7:e016651. doi:10.1136/bmjopen-2017-016651. Published by the BMJ Publishing Group Limited.
dc.description.abstractIntroduction: Older people with multimorbidities frequently access 999 ambulance services. When multimorbidities include dementia, the risk of ambulance use, accident and emergency (A&E) attendance and hospital admission are all increased, even when a condition is treatable in the community. People with dementia tend to do poorly in the acute hospital setting and hospital admission can result in adverse outcomes. This study aims to provide an evidence-based understanding of how older people living with dementia and other multimorbidities are using emergency ambulance services. It will also provide evidence of how paramedics make decisions about taking this group of patients to hospital, and what resources would allow them to make more person-focused decisions to enable optimal patient care. Methods and analysis: Phase 1: retrospective data analysis: quantitative analysis of ambulance service data will investigate: how often paramedics are called to older people with dementia; the amount of time paramedics spend on scene and the frequency with which these patients are transported to hospital. Phase 2: observational case studies: detailed case studies will be compiled using qualitative methods, including nonparticipant observation of paramedic decision-making, to understand why older people with multimorbidities including dementia are conveyed to A&E when they could be treated at home or in the community. Phase 3: needs analysis: nominal groups with paramedics will investigate and prioritise the resources that would allow emergency, urgent and out of hours care to be effectively delivered to these patients at home or in a community setting. Ethics and dissemination: Approval for the study has been obtained from the Health Research Authority (HRA) with National Health Service (NHS) Research Ethics Committee approval for phase 2 (16/NW/0803). The dissemination strategy will include publishing findings in appropriate journals, at conferences and in newsletters. We will pay particular attention to dissemination to the public, dementia organisations and ambulance services.en
dc.format.extent8
dc.language.isoeng
dc.relation.ispartofBMJ Open
dc.rightsOpen
dc.titleHome or hospital for people with dementia and one or more other multimorbidities: What is the potential to reduce avoidable emergency admissions? The HOMEWARD Project Protocolen
dc.contributor.institutionSchool of Health and Social Work
dc.contributor.institutionCentre for Research in Public Health and Community Care
dc.contributor.institutionOlder People's Health and Complex Conditions
dc.description.statusPeer reviewed
dc.identifier.urlhttp://bmjopen.bmj.com/content/7/4/e016651
dc.relation.schoolSchool of Health and Social Work
dc.description.versiontypeFinal Published version
dcterms.dateAccepted2017-04-01
rioxxterms.versionVoR
rioxxterms.versionofrecordhttps://doi.org/10.1136/bmjopen-2017- 016651
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue
herts.rights.accesstypeOpen


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