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    Evaluation of the effectiveness of a comprehensive care plan to reduce hospital acquired complications in an Australian hospital: protocol for a mixed-method preimplementation and postimplementation study.

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    Author
    Jessup, RL; Tacey, M; Glynn, M; Kirk, M; McKeown, L
    Date
    2020-07-20
    Source Title
    BMJ Open
    Publisher
    BMJ
    University of Melbourne Author/s
    Tacey, Mark
    Affiliation
    Melbourne School of Population and Global Health
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    Jessup, R. L., Tacey, M., Glynn, M., Kirk, M. & McKeown, L. (2020). Evaluation of the effectiveness of a comprehensive care plan to reduce hospital acquired complications in an Australian hospital: protocol for a mixed-method preimplementation and postimplementation study.. BMJ Open, 10 (7), pp.e034121-. https://doi.org/10.1136/bmjopen-2019-034121.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/251769
    DOI
    10.1136/bmjopen-2019-034121
    Open Access at PMC
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7375497
    Abstract
    INTRODUCTION: A new healthcare standard (Standard 5: Comprehensive Care) has been introduced by the Australian Commission on Safety and Quality in Healthcare. Standard 5 advocates for organisational leadership to develop and maintain systems and processes to deliver patient-centred comprehensive care plans that include appropriate screening to identify and mitigate risks associated with hospitalisation. The aim of this study is to evaluate the effectiveness and cost effectiveness of a comprehensive care and risk evaluation (Comprehensive Assessment and Risk Evaluation (CARE)) plan to reduce hospital acquired complications (HACs) in an Australian hospital network. METHODS AND ANALYSIS: This study will comprise a mixed-method pre and post implementation concurrent triangulation evaluation design. The primary clinical outcome will assess the reduction of routinely reported HACs (pressure care and falls), selected based on the likely reliability of routinely collected data prior to implementation. Secondary clinical outcomes will include length of stay and activity-based costing data for each episode, in-hospital mortality, expected and unplanned readmissions within 28 days, compliance with CARE plan completion and referrals for at risk patients, staff satisfaction, patient satisfaction and barriers and enablers to implementation. We expect that the incidence of other HACs (malnutrition, delirium, violence and aggression, and suicide and self-harm) may increase as routine methods for assessing risk were not in place prior to implementation of the CARE plan. We will therefore collect data on incidence of these HACs as tertiary outcomes. Our primary cost-effectiveness outcome will be calculation of an incremental cost-effectiveness ratio. ETHICS AND DISSEMINATION: Ethics approval has been received from Northern Health Low Risk Ethics Committee. The results of this study will be published in peer-reviewed journals and presented at conferences.

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