Clinical trial NCT02854826: Systems Addressing Frail Elders (SAFE) Care Implementation
Official title: Systems Addressing Frail Elders (SAFE) Care Implementation
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Frail Older Adutls
Keywords: Frail Older Adults, Interprofessional Team
Lead sponsor: Cedars-Sinai Medical Center
Sponsor class: OTHER
Collaborators: name: UniHealth Foundation
name: Ronald Reagan Medical Center
name: Huntington Hospital
name: Torrance Memorial
First posted: 2016-08-04
Enrollment: 330
Sex: ALL
Minimum age (years): 18
Maximum age (years): 110
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: OTHER
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: This project does not have a set recruitment/enrollment goal. Process evaluation information will be collected by interview and observation of leadership and staff at three implementation sites. Quality Improvement (QI) outcome data will be collected involving elderly patients (\> 65 years) admitted to two med-surg units at each of the three collaborating sites over designated time periods: One month prior to implementation and six month after intervention. QI data from each hospital will be de-identified and submitted to core research team for analysis of patient outcomes.

Brief summary: Systems Addressing Frail Elders (SAFE) Care is a nurse-led interprofessional team model to rapidly identify and provide safe and effective inpatient care to high risk older adults and help support their successful transition back to the community. Developed and demonstrated to be effective in one hospital - the model is now being disseminated and studied in three additional hospitals (multiple organizational case study).

Detailed description: Three Magnet hospitals in Los Angeles County (Huntington Hospital, Torrance Memorial Medical Center and Ronald Reagan UCLA Health System) are collaborating on this demonstration and evaluation project (Multiple Case-Study Design). The project will engage interprofessional hospital leadership; provide training and coaching in implementation processes of the SAFE Care model; and track outcome of the SAFE Care model as implemented in the three collaborating site hospitals (three case studies). The investigators hope to contribute to the existing state of the science in dissemination and implementation of evidenced-based innovations. The collective data from the three sites (collected through interviews with hospital leadership and staff and with de-identified patient data on program implementation outcomes) will provide information about the effectiveness of the implementation process and support further dissemination.

Eligibility criteria: Inclusion criteria:

Organizational Leadership Nursing Unit Leadership/staff Adults aged 65 years

Exclusion criteria:

65 years and older that are on hospice protocols or dying/comfort care protocols.

Primary outcomes:
measure: Implementation of SAFE Care model. Decreased Length of Stay
timeFrame: Up to 24 months
measure: Implementation of SAFE Care model. Reduced use of ICU days
timeFrame: Up to 24 months
measure: Implementation of SAFE Care model. Reduced hospital complications
timeFrame: Up to 24 months
Secondary outcomes:
Other outcomes:
Locations:
Study officials:
affiliation: Cedars Sinai
name: Lianna Z Ansryan, MSN
role: STUDY_DIRECTOR
References: