About this trial
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.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
a governance structure to organize and oversee HaH-services.
an IT-platform capable of managing data from and to HaH patients.
a safe communication pathway between HaH-patient and the hospital.
clear agreements on types of data to be exchanged between HaH-patient and hospital.
Disqualifiers
Hospitals that do not have or are not ready to secure relevant pre-requisites listed above (a to f).
Trial design
Parallel
Treatments tested in this trial
HaH education
BehavioralThe 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.
Treatment groups
Trial outcomes
Primary outcomes
HaH implementation
The primary outcome, HaH implementation at the organizational level, is defined as a change in clinical practice, measured by the proportion of eligible patients who receive HaH.
Secondary outcomes
Staff's motivation
Staff's motivation to work with HaH. Staff HaH motivation is measured by Intrinsic Motivation Inventory (IMI) Scale questionnaires. Participants will be presented with a series of statements and asked to indicate how true each statement is for them on a 7-point scale, where 1 represents 'not true at all' and 7 represents 'very true'.
Staff's knowledge
Staff members' knowledge on HaH. Staff's knowledge is collected as pre- and post-education questionnaires at baseline and at 6 months follow-up. The knowledge questionnaires have been developed prior to the study and has undergone pilot-validation with healthcare students, clinical staff, and education sector experts as part of the NorDigHE project.
Days hospitalized at home
Length of stay while hospitalized at home versus in the hospital. Measured using registry data for patients admitted to the department during trial.
30-day readmission
The percentage of patients that readmit to the hospital within 30 days with the same illness they were previously discharged. Measured using registry data for patients admitted to the department during the trial.
Sponsors and contacts
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Nordsjaellands Hospital
Lead sponsor
Sahlgrenska University Hospital
Collaborator
Lund University
Collaborator
University College Copenhagen
Collaborator
Ostfold University College
Collaborator
Region Capital Denmark
Collaborator