Evaluation of a Region-wide Residential In-Reach Program for Aged Care Homes in Regional and Rural Health Services A Stepped-Wedge Trial

What this Trial Is About

Researchers are evaluating a Residential In-Reach RIR program designed to provide timely care to residents in aged care homes within rural and regional areas. This program aims to reduce unnecessary hospital transfers by offering consultation services from a central hospital to aged care facilities. While previous evidence supports similar programs in urban settings, this trial focuses on assessing the clinical and cost-effectiveness, as well as implementation challenges, specifically in the Grampians regions rural and regional healthcare environment. The RIR program allows enrolled residential aged care homes to access a telehealth consultation service. Aged care staff can refer residents to a central hub where a nurse practitioner triages cases and recommends appropriate actions such as monitoring, comprehensive assessments, liaison with general practitioners for diagnosis and treatment, education and support for staff, or further referrals including geriatrician consultations or ambulance calls. The program is being gradually introduced across facilities in a stepped-wedge trial design, enabling comparison over time and between different locations. Participants include residents of aged care homes, their families, healthcare staff involved in the RIR program, and general practitioners serving these residents. The study will track emergency department presentations and urgent care visits over 14 months, along with hospital days, mortality locations, and program implementation factors such as barriers, enablers, stakeholder feedback, staff education attendance, and program adaptations. Data collection extends to one month after the trial to evaluate feasibility and acceptability. The trial duration and detailed follow-up will help understand the programs impact in rural and regional settings.

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