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Optimal healthcare delivery to care homes in the UK: a realist evaluation of what supports effective working to improve healthcare outcomes. / Gordon , Adam ; Goodman, Claire; Davies, Sue L; Dening , Tom ; Gage, Heather ; Meyer, Julienne; Schneider, Justine ; Bell , Brian ; Jordan , Jake ; Martin , Finbarr; Iliffe , Steve; Bowman, Clive; Gladman, John ; Victor, Christina; Mayrhofer, Andrea; Handley, Melanie; Zubair , Maria.

In: Age and Ageing, Vol. 47, No. 4, 01.07.2018, p. 595–603.

Research output: Contribution to journalArticle

Harvard

Gordon , A, Goodman, C, Davies, SL, Dening , T, Gage, H, Meyer, J, Schneider, J, Bell , B, Jordan , J, Martin , F, Iliffe , S, Bowman, C, Gladman, J, Victor, C, Mayrhofer, A, Handley, M & Zubair , M 2018, 'Optimal healthcare delivery to care homes in the UK: a realist evaluation of what supports effective working to improve healthcare outcomes', Age and Ageing, vol. 47, no. 4, pp. 595–603. https://doi.org/10.1093/ageing/afx195

APA

Gordon , A., Goodman, C., Davies, S. L., Dening , T., Gage, H., Meyer, J., Schneider, J., Bell , B., Jordan , J., Martin , F., Iliffe , S., Bowman, C., Gladman, J., Victor, C., Mayrhofer, A., Handley, M., & Zubair , M. (2018). Optimal healthcare delivery to care homes in the UK: a realist evaluation of what supports effective working to improve healthcare outcomes. Age and Ageing, 47(4), 595–603. https://doi.org/10.1093/ageing/afx195

Vancouver

Author

Gordon , Adam ; Goodman, Claire ; Davies, Sue L ; Dening , Tom ; Gage, Heather ; Meyer, Julienne ; Schneider, Justine ; Bell , Brian ; Jordan , Jake ; Martin , Finbarr ; Iliffe , Steve ; Bowman, Clive ; Gladman, John ; Victor, Christina ; Mayrhofer, Andrea ; Handley, Melanie ; Zubair , Maria. / Optimal healthcare delivery to care homes in the UK: a realist evaluation of what supports effective working to improve healthcare outcomes. In: Age and Ageing. 2018 ; Vol. 47, No. 4. pp. 595–603.

Bibtex

@article{756869e3c3d44f79b7d1ce781d1c8f53,
title = "Optimal healthcare delivery to care homes in the UK: a realist evaluation of what supports effective working to improve healthcare outcomes",
abstract = "Introduction: care home residents have high healthcare needs not fully met by prevailing healthcare models. This study explored how healthcare configuration influences resource use. Methods: a realist evaluation using qualitative and quantitative data from case studies of three UK health and social care economies selected for differing patterns of healthcare delivery to care homes. Four homes per area (12 in total) were recruited. A total of 239 residents were followed for 12 months to record resource-use. Overall, 181 participants completed 116 interviews and 13 focus groups including residents, relatives, care home staff, community nurses, allied health professionals and General Practitioners. Results: context-mechanism-outcome configurations were identified explaining what supported effective working between healthcare services and care home staff: (i) investment in care home-specific work that legitimises and values work with care homes; (ii) relational working which over time builds trust between practitioners; (iii) care which 'wraps around' care homes; and (iv) access to specialist care for older people with dementia. Resource use was similar between sites despite differing approaches to healthcare. There was greater utilisation of GP resource where this was specifically commissioned but no difference in costs between sites. Conclusion: activities generating opportunities and an interest in healthcare and care home staff working together are integral to optimal healthcare provision in care homes. Outcomes are likely to be better where: focus and activities legitimise ongoing contact between healthcare staff and care homes at an institutional level; link with a wider system of healthcare; and provide access to dementia-specific expertise.",
keywords = "Health services for the aged, Homes for the aged, Nursing homes, Older people, Primary care",
author = "Adam Gordon and Claire Goodman and Davies, {Sue L} and Tom Dening and Heather Gage and Julienne Meyer and Justine Schneider and Brian Bell and Jake Jordan and Finbarr Martin and Steve Iliffe and Clive Bowman and John Gladman and Christina Victor and Andrea Mayrhofer and Melanie Handley and Maria Zubair",
note = "This is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com",
year = "2018",
month = jul,
day = "1",
doi = "10.1093/ageing/afx195",
language = "English",
volume = "47",
pages = "595–603",
journal = "Age and Ageing",
issn = "0002-0729",
publisher = "Oxford University Press",
number = "4",

}

RIS

TY - JOUR

T1 - Optimal healthcare delivery to care homes in the UK: a realist evaluation of what supports effective working to improve healthcare outcomes

AU - Gordon , Adam

AU - Goodman, Claire

AU - Davies, Sue L

AU - Dening , Tom

AU - Gage, Heather

AU - Meyer, Julienne

AU - Schneider, Justine

AU - Bell , Brian

AU - Jordan , Jake

AU - Martin , Finbarr

AU - Iliffe , Steve

AU - Bowman, Clive

AU - Gladman, John

AU - Victor, Christina

AU - Mayrhofer, Andrea

AU - Handley, Melanie

AU - Zubair , Maria

N1 - This is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

PY - 2018/7/1

Y1 - 2018/7/1

N2 - Introduction: care home residents have high healthcare needs not fully met by prevailing healthcare models. This study explored how healthcare configuration influences resource use. Methods: a realist evaluation using qualitative and quantitative data from case studies of three UK health and social care economies selected for differing patterns of healthcare delivery to care homes. Four homes per area (12 in total) were recruited. A total of 239 residents were followed for 12 months to record resource-use. Overall, 181 participants completed 116 interviews and 13 focus groups including residents, relatives, care home staff, community nurses, allied health professionals and General Practitioners. Results: context-mechanism-outcome configurations were identified explaining what supported effective working between healthcare services and care home staff: (i) investment in care home-specific work that legitimises and values work with care homes; (ii) relational working which over time builds trust between practitioners; (iii) care which 'wraps around' care homes; and (iv) access to specialist care for older people with dementia. Resource use was similar between sites despite differing approaches to healthcare. There was greater utilisation of GP resource where this was specifically commissioned but no difference in costs between sites. Conclusion: activities generating opportunities and an interest in healthcare and care home staff working together are integral to optimal healthcare provision in care homes. Outcomes are likely to be better where: focus and activities legitimise ongoing contact between healthcare staff and care homes at an institutional level; link with a wider system of healthcare; and provide access to dementia-specific expertise.

AB - Introduction: care home residents have high healthcare needs not fully met by prevailing healthcare models. This study explored how healthcare configuration influences resource use. Methods: a realist evaluation using qualitative and quantitative data from case studies of three UK health and social care economies selected for differing patterns of healthcare delivery to care homes. Four homes per area (12 in total) were recruited. A total of 239 residents were followed for 12 months to record resource-use. Overall, 181 participants completed 116 interviews and 13 focus groups including residents, relatives, care home staff, community nurses, allied health professionals and General Practitioners. Results: context-mechanism-outcome configurations were identified explaining what supported effective working between healthcare services and care home staff: (i) investment in care home-specific work that legitimises and values work with care homes; (ii) relational working which over time builds trust between practitioners; (iii) care which 'wraps around' care homes; and (iv) access to specialist care for older people with dementia. Resource use was similar between sites despite differing approaches to healthcare. There was greater utilisation of GP resource where this was specifically commissioned but no difference in costs between sites. Conclusion: activities generating opportunities and an interest in healthcare and care home staff working together are integral to optimal healthcare provision in care homes. Outcomes are likely to be better where: focus and activities legitimise ongoing contact between healthcare staff and care homes at an institutional level; link with a wider system of healthcare; and provide access to dementia-specific expertise.

KW - Health services for the aged

KW - Homes for the aged

KW - Nursing homes

KW - Older people

KW - Primary care

UR - http://www.scopus.com/inward/record.url?scp=85054521359&partnerID=8YFLogxK

U2 - 10.1093/ageing/afx195

DO - 10.1093/ageing/afx195

M3 - Article

VL - 47

SP - 595

EP - 603

JO - Age and Ageing

JF - Age and Ageing

SN - 0002-0729

IS - 4

ER -