University of Hertfordshire

From the same journal

By the same authors

Effective heath care for older people living and dying in care homes: a realist review

Research output: Contribution to journalArticlepeer-review

Standard

Effective heath care for older people living and dying in care homes: a realist review. / Goodman, Claire; Dening , Tom ; Gordon , Adam ; Davies, Susan; Meyer, Julienne; Martin , Finbarr; Gladman, John ; Bowman, Clive; Victor, Christina.

In: BMC Health Services Research, Vol. 16, 269, 16.07.2016.

Research output: Contribution to journalArticlepeer-review

Harvard

Goodman, C, Dening , T, Gordon , A, Davies, S, Meyer, J, Martin , F, Gladman, J, Bowman, C & Victor, C 2016, 'Effective heath care for older people living and dying in care homes: a realist review', BMC Health Services Research, vol. 16, 269. https://doi.org/10.1186/s12913-016-1493-4

APA

Goodman, C., Dening , T., Gordon , A., Davies, S., Meyer, J., Martin , F., Gladman, J., Bowman, C., & Victor, C. (2016). Effective heath care for older people living and dying in care homes: a realist review. BMC Health Services Research, 16, [269]. https://doi.org/10.1186/s12913-016-1493-4

Vancouver

Author

Goodman, Claire ; Dening , Tom ; Gordon , Adam ; Davies, Susan ; Meyer, Julienne ; Martin , Finbarr ; Gladman, John ; Bowman, Clive ; Victor, Christina. / Effective heath care for older people living and dying in care homes: a realist review. In: BMC Health Services Research. 2016 ; Vol. 16.

Bibtex

@article{1fb0f4d483394b258f1c1d7c856d4d69,
title = "Effective heath care for older people living and dying in care homes: a realist review",
abstract = "BackgroundCare home residents in England have variable access to health care services. There is currently no coherent policy or consensus about the best arrangements to meet these needs. The purpose of this review was to explore the evidence for how different service delivery models for care home residents support and/or improve wellbeing and health-related outcomes in older people living and dying in care homes.MethodsWe conceptualised models of health care provision to care homes as complex interventions. We used a realist review approach to develop a preliminary understanding of what supported good health care provision to care homes. We completed a scoping of the literature and interviewed National Health Service and Local Authority commissioners, providers of services to care homes, representatives from the Regulator, care home managers, residents and their families. We used these data to develop theoretical propositions to be tested in the literature to explain why an intervention may be effective in some situations and not others. We searched electronic databases and related grey literature. Finally the findings were reviewed with an external advisory group.ResultsStrategies that support and sustain relational working between care home staff and visiting health care professionals explained the observed differences in how health care interventions were accepted and embedded into care home practice. Actions that encouraged visiting health care professionals and care home staff jointly to identify, plan and implement care home appropriate protocols for care, when supported by ongoing facilitation from visiting clinicians, were important. Contextual factors such as financial incentives or sanctions, agreed protocols, clinical expertise and structured approaches to assessment and care planning could support relational working to occur, but of themselves appeared insufficient to achieve change.ConclusionHow relational working is structured between health and care home staff is key to whether health service interventions achieve health related outcomes for residents and their respective organisations. The belief that either paying clinicians to do more in care homes and/or investing in training of care home staff is sufficient for better outcomes was not supported.",
keywords = "Long-tern care , Realist review, care home, older people, health outcomes",
author = "Claire Goodman and Tom Dening and Adam Gordon and Susan Davies and Julienne Meyer and Finbarr Martin and John Gladman and Clive Bowman and Christina Victor",
note = "{\textcopyright} 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. 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.",
year = "2016",
month = jul,
day = "16",
doi = "10.1186/s12913-016-1493-4",
language = "English",
volume = "16",
journal = "BMC Health Services Research",
issn = "1472-6963",
publisher = "BioMed Central",

}

RIS

TY - JOUR

T1 - Effective heath care for older people living and dying in care homes: a realist review

AU - Goodman, Claire

AU - Dening , Tom

AU - Gordon , Adam

AU - Davies, Susan

AU - Meyer, Julienne

AU - Martin , Finbarr

AU - Gladman, John

AU - Bowman, Clive

AU - Victor, Christina

N1 - © 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. 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.

PY - 2016/7/16

Y1 - 2016/7/16

N2 - BackgroundCare home residents in England have variable access to health care services. There is currently no coherent policy or consensus about the best arrangements to meet these needs. The purpose of this review was to explore the evidence for how different service delivery models for care home residents support and/or improve wellbeing and health-related outcomes in older people living and dying in care homes.MethodsWe conceptualised models of health care provision to care homes as complex interventions. We used a realist review approach to develop a preliminary understanding of what supported good health care provision to care homes. We completed a scoping of the literature and interviewed National Health Service and Local Authority commissioners, providers of services to care homes, representatives from the Regulator, care home managers, residents and their families. We used these data to develop theoretical propositions to be tested in the literature to explain why an intervention may be effective in some situations and not others. We searched electronic databases and related grey literature. Finally the findings were reviewed with an external advisory group.ResultsStrategies that support and sustain relational working between care home staff and visiting health care professionals explained the observed differences in how health care interventions were accepted and embedded into care home practice. Actions that encouraged visiting health care professionals and care home staff jointly to identify, plan and implement care home appropriate protocols for care, when supported by ongoing facilitation from visiting clinicians, were important. Contextual factors such as financial incentives or sanctions, agreed protocols, clinical expertise and structured approaches to assessment and care planning could support relational working to occur, but of themselves appeared insufficient to achieve change.ConclusionHow relational working is structured between health and care home staff is key to whether health service interventions achieve health related outcomes for residents and their respective organisations. The belief that either paying clinicians to do more in care homes and/or investing in training of care home staff is sufficient for better outcomes was not supported.

AB - BackgroundCare home residents in England have variable access to health care services. There is currently no coherent policy or consensus about the best arrangements to meet these needs. The purpose of this review was to explore the evidence for how different service delivery models for care home residents support and/or improve wellbeing and health-related outcomes in older people living and dying in care homes.MethodsWe conceptualised models of health care provision to care homes as complex interventions. We used a realist review approach to develop a preliminary understanding of what supported good health care provision to care homes. We completed a scoping of the literature and interviewed National Health Service and Local Authority commissioners, providers of services to care homes, representatives from the Regulator, care home managers, residents and their families. We used these data to develop theoretical propositions to be tested in the literature to explain why an intervention may be effective in some situations and not others. We searched electronic databases and related grey literature. Finally the findings were reviewed with an external advisory group.ResultsStrategies that support and sustain relational working between care home staff and visiting health care professionals explained the observed differences in how health care interventions were accepted and embedded into care home practice. Actions that encouraged visiting health care professionals and care home staff jointly to identify, plan and implement care home appropriate protocols for care, when supported by ongoing facilitation from visiting clinicians, were important. Contextual factors such as financial incentives or sanctions, agreed protocols, clinical expertise and structured approaches to assessment and care planning could support relational working to occur, but of themselves appeared insufficient to achieve change.ConclusionHow relational working is structured between health and care home staff is key to whether health service interventions achieve health related outcomes for residents and their respective organisations. The belief that either paying clinicians to do more in care homes and/or investing in training of care home staff is sufficient for better outcomes was not supported.

KW - Long-tern care

KW - Realist review

KW - care home

KW - older people

KW - health outcomes

UR - http://www.biomedcentral.com/1472-6963/16/269

U2 - 10.1186/s12913-016-1493-4

DO - 10.1186/s12913-016-1493-4

M3 - Article

VL - 16

JO - BMC Health Services Research

JF - BMC Health Services Research

SN - 1472-6963

M1 - 269

ER -