Hospital-at-Home Education as Implementation Tool - RCT

NCT ID: NCT07166653

Last Updated: 2025-09-10

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

14 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-09-01

Study Completion Date

2026-12-31

Brief Summary

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To enhance implementation of Hospital-at-home (HaH) in Scandinavia, the Nordic Digital Health \& Education (NorDigHE) project has developed a comprehensive virtual education on HaH for clinical staff. The goal of this clinical trial is to evaluate whether an online education for clinical staff can enhance the implementation of HaH services in hospitals across Denmark, Norway, and Sweden.

The primary outcome of the RCT is HaH implementation measured at organization level, understood as a change in clinical practice by increased HaH activity. Secondary outcomes are HaH knowledge and motivation among clinical staff as well as patient days in hospital, days hospitalized at home, 30-day readmission, and mortality.

Researchers will compare hospitals receiving the NorDigHE education (intervention group) to hospitals continuing treatment as usual (control group) to see if the education leads to greater adoption of HaH and changes in service delivery.

Participants will:

* Complete baseline, 3-month, and 6-month surveys assessing HaH activity, staff knowledge, and motivation.
* Participate in a 12-month follow-up assessment (intervention group only).
* Be invited (patients, staff, and management) to take part in semi-structured interviews to share experiences and preferences related to HaH.
* (For staff in the intervention group) Complete the NorDigHE virtual education program embedded in the WHO Fast-IM.

After the study, the control group will be offered access to the NorDigHE education as a participant retention measure.

Detailed Description

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Background: In response to increasing pressures on healthcare systems due to aging populations, and increasing shortages of clinical staff, increased use of digital service designs has been recommended by most governments in Scandinavian and European countries. Virtually supported Hospital-at-Home (HaH) models, delivering acute hospital services in-home have been shown to be both feasible and beneficial. Nevertheless, implementation and scaling barriers are major challenges. To enhance implementation of HaH in Scandinavia, the Nordic Digital Health \& Education (NorDigHE) project has developed a compre-hensive virtual education on HaH for clinical staff. The present study aims to evaluate the implementation impact of the NorDigHE education embedded in the WHO Fast-track Implementation Model (WHO Fast-IM).

Methods and analysis: We use a randomized design and nested qualitative studies to meet the aim. Via open-call, hospitals will be recruited in Denmark, Norway, and Sweden and randomized to either receive the education embedded in the WHO Fast-IM or to continue treatment as usual. The primary outcome of the RCT is HaH implementation measured at organization level, understood as a change in clinical practice by increased HaH activity. Secondary outcomes are HaH knowledge and motivation among clinical staff as well as patient days in hospital, days hospitalized at home, 30-day readmission, and mortality. Data are collected at baseline, after 3, and 6 months. A 12-month maintenance measurement is performed in the intervention group. Post-study, the control group is offered the NorDigHE education as a participant re-tention measure. In addition, the attitudes, experiences, and preferences of HaH among patients, clinical staff, and management are collected via nested semi-structured interviews.

Conditions

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Hospital

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The study is designed as a two-armed, multicenter, superiority, cluster-randomized clinical trial with the hospital as the unit of randomization. The participating hospitals will autonomously select the relevant clinical departments and related staff to undergo the education tested. Data are collected at baseline, after 3, and 6 months. The intervention group also collects a 12-month maintenance assessment.
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Intervention group

The intervention group receives the NorDigHE HaH education embedded in the WHO Fast-IM.

Group Type EXPERIMENTAL

HaH education

Intervention Type BEHAVIORAL

The intervention consists of the online NorDigHE HaH education with tailored implementation tools em-bedded in the WHO Fast-IM. The education is delivered online and asynchronously, combining e-learning, simulations, reflection exercises, and practical task training.

The trial has adopted the evidence-based WHO Fast-track Implementation Model (WHO Fast-IM) as a framework to support the effectiveness and reporting of the implementation, and the tailored implementation tools embedded in the model will be provided as part of the intervention to support in-tegration into daily clinical routines. The tailored toolbox consists of workshops, introductory meetings, written guides, and access to a hotline staffed by project specialists to facilitate implementation.

Control group

The control group continues treatment as usual over a 6-month period. To enhance participant retention, the control group will be offered the education after study completion and as a quality initiative.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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HaH education

The intervention consists of the online NorDigHE HaH education with tailored implementation tools em-bedded in the WHO Fast-IM. The education is delivered online and asynchronously, combining e-learning, simulations, reflection exercises, and practical task training.

The trial has adopted the evidence-based WHO Fast-track Implementation Model (WHO Fast-IM) as a framework to support the effectiveness and reporting of the implementation, and the tailored implementation tools embedded in the model will be provided as part of the intervention to support in-tegration into daily clinical routines. The tailored toolbox consists of workshops, introductory meetings, written guides, and access to a hotline staffed by project specialists to facilitate implementation.

Intervention Type BEHAVIORAL

Other Intervention Names

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NorDigHE education

Eligibility Criteria

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Inclusion Criteria

Hospitals with clinical departments treating acutely ill in-patients that have, or are ready to establish, the prerequisites and infrastructure for HaH - regardless of the specific approach, envisioned HaH model, primary sector collaborations, or local sector collaboration agreements and frameworks. Each hospital must have or be ready to establish:

1. a governance structure to organize and oversee HaH-services.
2. an IT-platform capable of managing data from and to HaH patients.
3. a safe communication pathway between HaH-patient and the hospital.
4. clear agreements on types of data to be exchanged between HaH-patient and hospital.
5. agreements on roles, responsibilities, and capacity (incl. possibly primary sector entities).
6. clinical guidelines, standard operating procedures, and action plans to support the HaH work.

Exclusion Criteria

* Hospitals that do not have or are not ready to secure relevant pre-requisites listed above (a to f).
Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Sahlgrenska University Hospital

OTHER

Sponsor Role collaborator

Lund University

OTHER

Sponsor Role collaborator

University College Copenhagen

OTHER

Sponsor Role collaborator

Ostfold University College

OTHER

Sponsor Role collaborator

Region Capital Denmark

OTHER

Sponsor Role collaborator

Nordsjaellands Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Thea K Fischer

Role: PRINCIPAL_INVESTIGATOR

Forskningsafdelingen, Nordsjællands Hospital

Locations

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Nordsjællands Hospital

Hillerød, Capitol Region of Denmark, Denmark

Site Status RECRUITING

University College of Østfold

Fredrikstad, Østfold fylke, Norway

Site Status RECRUITING

Sahlgrenska University hospital

Göteborg, Skåne County, Sweden

Site Status RECRUITING

Countries

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Denmark Norway Sweden

Central Contacts

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Mie H Martinussen

Role: CONTACT

+45 20529362

Jeff K Svane

Role: CONTACT

+45 20544105

Facility Contacts

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Mie H Martinussen

Role: primary

+45 20529362

Vigdis Abrahamsen Grøndahl, Professor

Role: primary

+47 930 52 634

Malin Portillo

Role: primary

+46 (0)766974418

References

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Related Links

Access external resources that provide additional context or updates about the study.

https://iris.who.int/handle/10665/250368

World Health Organization, Global strategy on human resources for health: workforce 2030. Geneva: World Health Organization, 2016. Seen: 6. juni 2024.

https://cordis.europa.eu/programme/id/H2020-EU.3.1.

European Commission, "CORDIS programne: Societal Challenges - Health, demographic change and well-being", EU, H2020-EU.3.1., 2014. \[Online\].

https://www.regjeringen.no/contentassets/337fef958f2148bebd326f0749a1213d/no/pdfs/nou202320230004000dddpdfs.pdf

NOU: Norges offentlige utredninger, "Tid for handling: Personellet i en bærekraftig helse- og omsorgstjeneste", Departementenes sikkerhets- og serviceorganisasjon Teknisk redaksjon, 2023:4, 2023. \[Online\].

https://www.ism.dk/Media/638336462586551242/Robusthed-Samlet-Rapport-TILG.pdf

Kommissionen for robusthed i sundhedsvæsenet, "Robusthedskommissionens anbefalinger", sep. 2023. \[Online\].

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M. Monalto, "Definition: What is Hospital at Home? \| WHAHC", WHAHC-community. Seen: 4. februar 2025. \[Online\].

https://www.nordighe.org

"NorDigHE.org", Nordighe. Seen: 4. februar 2025. \[Online\]

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D. L. Kirkpatrick, "The Kirkpatrick Model", Kirkpatrick Partners, LLC.

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Erfaringer med Fremskudt akutfunktion på kommunale sengepladser i eHospitalet, Region Sjælland

Other Identifiers

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NorDigHE HaH RCT Protocol

Identifier Type: -

Identifier Source: org_study_id

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