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Randomized Controlled Trial
. 2025 May 3;54(5):afaf142.
doi: 10.1093/ageing/afaf142.

Improving the safety and experience of transitions from hospital to home: a cluster randomised controlled trial of an intervention to involve older people in their care (Your Care Needs You)

Jenni Murray  1 , Kalpita Baird  2 , Stephen Brealey  2 , Laura Mandefield  2 , Gerry Richardson  3 , Jane O'Hara  4 , Robbie Foy  5 , Laura Sheard  2 , Alison Cracknell  6 , Alfredo Palacios  7 , Simon Walker  2 , Ed Breckin  1 , Lubena Mirza  1 , Ruth Baxter  5 , Catherine Hewitt  2 , Rebecca Lawton  8
Affiliations
Randomized Controlled Trial

Improving the safety and experience of transitions from hospital to home: a cluster randomised controlled trial of an intervention to involve older people in their care (Your Care Needs You)

Jenni Murray et al. Age Ageing. .

Erratum in

Abstract

Background: Transitions from hospital to home are risky for older people. The role of patient involvement in supporting safe transitions is unclear.

Objective: To assess the clinical effectiveness of an intervention to improve the safety and experience of care transitions for older people.

Trial design: Cluster randomised controlled trial.

Participants: Eleven National Health Service acute hospital trusts and 42 wards (clusters) routinely providing care for older people (aged 75 years and older) planning to transition back home.

Intervention: Patient involvement ward-level intervention-Your Care Needs You (YCNY).

Outcomes: Unplanned hospital readmission rates within 30 days of discharge (primary outcome). Secondary outcomes included readmissions at 60 and 90 days post-discharge, experience of transitions and safety events.

Randomisation: Ward as the unit of randomisation from varying medical specialities randomised to YCNY or care-as-usual on a 1:1 basis.

Blinding: Ward staff, research nurses and researchers were unblinded. Patients were unaware of treatment allocation. Statisticians were blinded to the primary outcome data until statistical analysis plan sign-off.

Results: Using a mixed effects logistic regression we saw no significant difference in unplanned 30-day readmission rates (OR 0.93; 95% CI, 0.78 to 1.10; P = .372) between intervention (17%) and control (19%). At all timepoints, rates were lower in the intervention group. The total number of readmissions was lower in the intervention group (all timepoints) reaching statistical significance across 90-days with 13% fewer readmissions (IRR: 0.87; 95% CI 0.76 to 0.99) than the control. At 30-days only, intervention group patients reported better experiences of transitions and significantly fewer safety events. Serious adverse events were similarly observed in both groups [YCNY: 26 (52.0%), Care-as-usual: 24 (48.0%)]. None related to treatment.

Conclusions: YCNY did not significantly impact on unplanned hospital readmissions at 30 days but in some secondary outcomes we did find evidence of clinical benefit.

Keywords: involvement; older people; safety; transitions.

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Conflict of interest statement

None declared.

Figures

Graphical Abstract
Graphical Abstract
Figure 1
Figure 1
CONSORT flow diagram showing flow of patients in the primary cohort study.
Figure 2
Figure 2
CONSORT flow diagram showing flow of participants in the nested cohort study.
See this image and copyright information in PMC

References

    1. Glans M, Kragh Ekstam A, Jakobsson U et al. Risk factors for hospital readmission in older adults within 30 days of discharge — a comparative retrospective study. BMC Geriatr. 2020;20:467. 10.1186/s12877-020-01867-32. - DOI - PMC - PubMed
    1. Pedersen MK, Meyer G, Uhrenfeldt L. Risk factors for acute care hospital readmission in older persons in western countries: a systematic review. JBI Database System Rev Implement Rep. 2017;15:454–85. 10.11124/JBISRIR-2016-003267. - DOI - PubMed
    1. Forster AJ, Murff HJ, Peterson JF et al. The incidence and severity of adverse events affecting patients after discharge from the hospital. Ann Intern Med. 2003;138:161–7. - PubMed
    1. Auerbach AD, Kripalani S, Vasilevskis EE et al. Preventability and causes of readmissions in a National Cohort of general medicine patients. JAMA Intern Med. 2016;176:484–93. 10.1001/jamainternmed.2015.7863. - DOI - PMC - PubMed
    1. Blunt I, Bardsley M, Grove A et al. Classifying emergency 30-day readmissions in England using routine hospital data 2004-2010: What is the scope for reduction? Emerg Med J. 2015;32:44–50. 10.1136/emermed-2013-202531. - DOI - PMC - PubMed

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