Browsing by Author "Devi, R."

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    Improving the quality of care in care homes using the Quality Improvement Collaborative approach: lessons learnt from six projects conducted in the UK and the Netherlands
    (MDPI, 2020) Hinsliff-Smith, K.; Devi, R.; Martin, G.; Banerjee, J.; Butler, L.; Pattison, T.; Cruickshank, L.; Maries-Tillott, C.; Wilson, Tracie; Damery, S.; Meyer, J.; Poot, A.; Chamberlaine, P.; Harvey, D.; Giebel, C.; Chadbourne, N.; Gordon, Adam Lee
    The Breakthrough Series Quality Improvement Collaborative (QIC) initiative is a well-developed and widely used approach but most of what we know about it has come from healthcare settings. In this article, those leading QICs to improve care in care homes provide detailed accounts of six QICs, and share their learning of applying the QIC approach in the care home sector. Overall, five care home specific lessons were learnt: i) plan for the resource needed to support collaborative teams with collecting, processing, and interpreting data ii) create encouraging and safe working environments to help collaborative team members feel valued, iii) recruit collaborative teams, QIC leads and facilitators who have established relationships with care homes, iv) regularly check project ideas are aligned with team members’ job roles, responsibility and priorities, and v) work flexibly and accept that planned activities may need adapting as the project progresses. These insights are targeted at teams delivering QICs in care homes. These insights demonstrate the need to consider the care home context when applying improvement tools and techniques in this setting.
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    Research on Long-Term Care Homes for Older People in Brazil: Protocol for Scoping Review
    (East Midlands Research into Ageing Network (EMRAN) Discussion Paper EMRAN, 2019-11-26) Hinsliff-Smith, K.; Wachholz, P. A.; Ricci, N. A.; Devi, R.; Shepard, V.; Villas-Boas, P. J. F.; Jacinto, A. F.; Watanabe, H. A. W.; Oliveira, D.; Gordon, Adam Lee
    Background The fast growth of the ageing population in low and middle-income countries, such as Brazil, has allowed little time for social and health care systems to adapt. As the care needs for the most vulnerable and frail older people become increasingly complex, services and governments need to ensure that long term care homes deliver high-quality and evidence-based care to meet their healthcare needs. Aim To examine and map the range of research undertaken in Brazil regarding care homes published in peer reviewed journals. Method This scoping review will consider all relevant peer-reviewed primary studies fully or partly conducted in Brazilian care homes including those which consider workforce (for example, e.g. healthcare professionals, care staff, and management level staff) and care home residents (older people aged 60 years and above), using empirical and original research focused on any health related topic. The searches will be conducted using bibliographic databases (MEDLINE, EMBASE, LILACS and Google Scholar) and manual searching of the reference lists of relevant studies published in English, Portuguese or Spanish from inception up to 2018. Two authors will independently screen each document by title and abstract against the eligibility criteria. In case of disagreement, a third reviewer will be consulted. Data from the included studies will be extracted and reported using tables, graphs, and narrative accounts using elements of content analysis. The Mixed Methods Appraisal Tool will be used to appraise the methodological quality of the included studies.
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    Statistical analysis plan for the proactive healthcare of older people in care homes (PEACH) study
    (East Midlands Research into Ageing Network (EMRAN) Discussion Paper Series, 2018-09) Usman, A.; Lewis, S.; Jordan, J.; Gage, H.; Housley, G.; Hinsliff-Smith, K.; Long, A.; Devi, R.; Chadborn, N.
    The Proactive Healthcare for Older People living in Care Homes (PEACH) study aims to evaluate whether Quality Improvement Collaboratives can be an effective way to work with local health and social care stakeholders, including representatives of the care home sector, to implement Comprehensive Geriatric Assessment (CGA) in the care home setting. It will enlist the support of four Area Improvement Collaboratives from South Nottinghamshire, UK to make changes to enable CGA in care homes in their areas. The primary outcome measure is health-related quality of life (HRQoL), measured using the EuroQoL 5-domain 5-level (EQ-5D-5L) index. A cluster-randomised (where care homes represent clusters) approach will be taken. Secondary outcome measures will be Health Service Resource by service category. These will be analysed using an interrupted time series approach. The methodology is challenging and introduces the need to control for multiple sources of contamination, clustering, time effects including lag effect and measurement issues with the primary outcome variable, including the uncertain reliability of care home staff proxy responses. This paper outlines the statistical analysis plan for the study, describing how these challenges have been addressed. It acts as reference point for further publications from the PEACH study.