Evaluation of a Residential In-Reach Program in Regional and Rural Australia

NCT ID: NCT06901167

Last Updated: 2025-05-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-05-01

Study Completion Date

2026-06-30

Brief Summary

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Residential In-Reach (RIR) programs are designed to provide responsive care for residents in residential aged care homes (RACH) with the aim of avoiding unnecessary hospital transfers. The evidence for their clinical and cost-effectiveness and implementation has been established in urban settings, but there is a small amount of low-quality evidence for rural and regional settings. The Grampians Region Health Service Partnership Resi-In-Reach Redesign Committee will be implementing a new RIR program to be offered to all RACHs in the Grampians region, this project aims to evaluate the clinical and cost-effectiveness of this program, and its implementation in the rural and regional setting. A stepped-wedge trial will be conducted so that as the RIR program is gradually rolled-out across the region, outcomes can be compared in the same facilities across time and between different facilities. The primary outcome measure will be presentation to emergency departments and urgent care centres, and data will also be collected on other clinical outcomes and barriers and enablers of implementing the program. It is anticipated that there will be a reduction in hospital presentations, and a range of barriers and enablers unique to the rural and regional setting will emerge.

Detailed Description

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Conditions

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Aged Acute Disease

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

This will be a stepped-wedge trial, in which all enrolled facilities and participants will receive the same intervention, but the intervention roll-out will be conducted in a sequential manner based on a randomised order. During the 14 months of the trial, all facilities and participants will receive the same intervention, but for different lengths of time depending on the randomisation.
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Residential-in-reach

All enrolled residential aged care homes will be able to access the residential-in-reach (RIR) program intervention. The RIR program provides a consultation service from a central hospital to an aged care facility in the Grampians region in the state of Victoria, Australia. Aged care staff will make a telehealth referral to central hub, where a nurse practitioner will triage the patient and make recommendations (for example, monitor resident condition, more examples: comprehensive assessment for unwell residents, liaison with the General Practitioners for diagnosis and treatment plan, provide education and support to staff) or further referrals (for example, refer to geriatrician or call an ambulance).

Group Type EXPERIMENTAL

Residential In-Reach Program

Intervention Type OTHER

All enrolled residential aged care homes will be able to access the residential-in-reach (RIR) program intervention. The RIR program provides a consultation service from a central hospital to an aged care facility in the Grampians region in the state of Victoria, Australia. Aged care staff will make a telehealth referral to central hub, where a nurse practitioner will triage the patient and make recommendations (for example, monitor resident condition, more examples: comprehensive assessment for unwell residents, liaison with the General Practitioners for diagnosis and treatment plan, provide education and support to staff) or further referrals (for example, refer to geriatrician or call an ambulance).

Interventions

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Residential In-Reach Program

All enrolled residential aged care homes will be able to access the residential-in-reach (RIR) program intervention. The RIR program provides a consultation service from a central hospital to an aged care facility in the Grampians region in the state of Victoria, Australia. Aged care staff will make a telehealth referral to central hub, where a nurse practitioner will triage the patient and make recommendations (for example, monitor resident condition, more examples: comprehensive assessment for unwell residents, liaison with the General Practitioners for diagnosis and treatment plan, provide education and support to staff) or further referrals (for example, refer to geriatrician or call an ambulance).

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Health services that have emergency departments and/or emergency care centres that admit residents from residential aged care homes (RACH)
* RACHs that do not currently have access to RIR programs
* health service staff who have been involved with the set-up and delivery of the RIR program,
* RACH staff who have experience of or accessing the RIR service for residents at least once,
* residents living at a RACH who has experienced receiving medical care from the RIR program and can provide informed consent, or a family member of the resident,
* general practitioners whose case load includes residents from RACHs.

Exclusion Criteria

• RACHs that already have access to a RIR program will be excluded
Minimum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Deakin University

OTHER

Sponsor Role collaborator

Monash University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Terry Haines

Role: PRINCIPAL_INVESTIGATOR

Monash University

Locations

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East Grampians Health Service

Ararat, Victoria, Australia

Site Status RECRUITING

Grampians Health

Ballarat, Victoria, Australia

Site Status RECRUITING

Beaufort and Skipton Health Service

Beaufort, Victoria, Australia

Site Status RECRUITING

Central Highlands Rural Health

Daylesford, Victoria, Australia

Site Status RECRUITING

Maryborough District Health Service

Maryborough, Victoria, Australia

Site Status RECRUITING

West Wimmera Health Service

Nhill, Victoria, Australia

Site Status RECRUITING

East Wimmera Health Service

Saint Arnaud, Victoria, Australia

Site Status RECRUITING

Rural Northwest Health

Warracknabeal, Victoria, Australia

Site Status RECRUITING

Countries

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Australia

Central Contacts

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Dai Pu

Role: CONTACT

61 03 9904 4004

Catherine Huggins

Role: CONTACT

Facility Contacts

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Michele Colin

Role: primary

61 03 5352 9300

Narelle Ryan

Role: primary

61 0417 590 832

Andrea Flenley

Role: primary

61 03 5349 1600

Susan Jennings

Role: primary

61 03 5321 6500

Debbie Rogers

Role: primary

61 03 5461 0333

Cheree Schneider

Role: primary

61 03 5391 4222

Genette Heslop

Role: primary

61 03 5477 2100

Joseph Bermudo

Role: primary

61 03 5396 1200

References

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Sunner C, Giles MT, Parker V, Dilworth S, Bantawa K, Kable A, Oldmeadow C, Foureur M. PACE-IT study protocol: a stepped wedge cluster randomised controlled trial evaluating the implementation of telehealth visual assessment in emergency care for people living in residential aged-care facilities. BMC Health Serv Res. 2020 Jul 20;20(1):672. doi: 10.1186/s12913-020-05539-1.

Reference Type BACKGROUND
PMID: 32690008 (View on PubMed)

Sunner C, Giles MT, Kable A, Foureur M. Experiences of nurses working in RACFs and EDs utilising visual telehealth consultation to assess the need for RACF resident transfer to ED: A qualitative descriptive study. J Clin Nurs. 2023 Aug;32(15-16):4694-4709. doi: 10.1111/jocn.16529. Epub 2022 Sep 8.

Reference Type BACKGROUND
PMID: 36081333 (View on PubMed)

Lukin B, Fan LJ, Zhao JZ, Sun JD, Dingle K, Purtill R, Tapp S, Hou XY. Emergency department use among patients from residential aged care facilities under a Hospital in the Nursing Home scheme in public hospitals in Queensland Australia. World J Emerg Med. 2016;7(3):183-90. doi: 10.5847/wjem.j.1920-8642.2016.03.004.

Reference Type BACKGROUND
PMID: 27547277 (View on PubMed)

Hullick C, Conway J, Hall A, Murdoch W, Cole J, Hewitt J, Oldmeadow C, Attia J. Video-telehealth to support clinical assessment and management of acutely unwell older people in Residential Aged Care: a pre-post intervention study. BMC Geriatr. 2022 Jan 10;22(1):40. doi: 10.1186/s12877-021-02703-y.

Reference Type BACKGROUND
PMID: 35012480 (View on PubMed)

Haines TP, Palmer AJ, Tierney P, Si L, Robinson AL. A new model of care and in-house general practitioners for residential aged care facilities: a stepped wedge, cluster randomised trial. Med J Aust. 2020 May;212(9):409-415. doi: 10.5694/mja2.50565. Epub 2020 Apr 1.

Reference Type BACKGROUND
PMID: 32237279 (View on PubMed)

Chambers D, Cantrell A, Preston L, Marincowitz C, Wright L, Conroy S, Lee Gordon A. Reducing unplanned hospital admissions from care homes: a systematic review. Health Soc Care Deliv Res. 2023 Oct;11(18):1-130. doi: 10.3310/KLPW6338.

Reference Type BACKGROUND
PMID: 37916580 (View on PubMed)

Other Identifiers

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HREC/112397/GHSJOG-2025-462490

Identifier Type: -

Identifier Source: org_study_id

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