EnRICH: an integrated geriatrician-led Interface model associated with reduced emergency admissions among care home residents.
Background Care home residents are a vulnerable population with high rates of emergency hospital use. Despite national guidance promoting multidisciplinary care, evidence for models involving geriatricians remains limited. The Enhanced Reviews in Care Homes service was developed to address this gap,...
| Publicado en: | Age & Ageing Vol. 55; no. 7; pp. 1 - 11 |
|---|---|
| Autores principales: | , , , , , , , , , |
| Formato: | Artículo |
| Publicado: |
Oxford University Press / USA
Jul2026
|
| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=195867352&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 195867352 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Jul2026 vid: 55 iid: 7 pid: 622 pub: Oxford University Press / USA artinfo: ui: 195867352 10.1093/ageing/afag195 ppf: 1 ppct: 10 formats: tig: atl: EnRICH: an integrated geriatrician-led Interface model associated with reduced emergency admissions among care home residents. aug: au: Love, Catriona Butler, Matthew J D'Souza, Shaun Rose, Alexander Gesso, Jessica Di Ford, Joanna Poel, Lelane Van Der Simpson, Rhian Hampton, Joanna Biram, Richard W S affil: Cambridge University Hospitals NHS Foundation Trust, Department of Medicine for the Elderly, Cambridge CB2 0QQ, UK Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge Rehabilitation Unit (CRU), UK Cambridge University Hospitals NHS Foundation Trust, Department of Medicine for the Elderly, Cambridge CB2 0QQ, UKSchool of Clinical Medicine, University of Cambridge, Cambridge, UK su: Patients Interprofessional relations Hospital admission & discharge Continuing education Advance directives (Medical care) Poisson distribution Research funding Hospital emergency services Descriptive statistics Geriatric assessment Data analysis software Confidence intervals Length of stay in hospitals Regression analysis sug: subj: Patients Interprofessional relations Hospital admission & discharge Continuing education Advance directives (Medical care) Professional and Management Development Training Poisson distribution Research funding Hospital emergency services Descriptive statistics Geriatric assessment Data analysis software Confidence intervals Length of stay in hospitals Regression analysis keyword: advance care planning aged care home medicine community community comprehensive Geriatric assessment copyrightHolder:British Geriatrics Society copyrightYear:2026 emergency service geriatrician outreach geriatricians hospital hospital care home Interface https://dx.doi.org/10.1093/ageing/afag195 inLanguage:en internship and residency length of stay medical residencies older people publisher:Oxford University Press sameAs:https://pubmed.ncbi.nlm.nih.gov/42532500/ statistical process control advance care planning aged care home medicine community community comprehensive Geriatric assessment copyrightHolder:British Geriatrics Society copyrightYear:2026 emergency service geriatrician outreach geriatricians hospital hospital care home Interface https://dx.doi.org/10.1093/ageing/afag195 inLanguage:en internship and residency length of stay medical residencies older people publisher:Oxford University Press sameAs:https://pubmed.ncbi.nlm.nih.gov/42532500/ statistical process control ab: Background Care home residents are a vulnerable population with high rates of emergency hospital use. Despite national guidance promoting multidisciplinary care, evidence for models involving geriatricians remains limited. The Enhanced Reviews in Care Homes service was developed to address this gap, providing proactive and reactive geriatrician input across the community/hospital interface. Methods We conducted a service evaluation using a controlled before-and-after design. The intervention was introduced sequentially across care homes between October 2024 and December 2025. Statistical process control (SPC) charts were generated monthly to monitor performance. Outcomes before and after implementation in intervention homes were compared with contemporaneous trends in all non-intervention care homes in the catchment area and analysed using longitudinal fixed effects regression. The primary outcome was monthly non-elective admissions. Secondary outcomes were monthly emergency department (ED) attendances and length of hospital stay. Results SPC charts demonstrated special-cause variation in the monthly non-elective admission rate and ED attendance rate. Statistical analyses of 6448 ED attendances (1611 from intervention homes; 4837 from controls), showed a significant reduction in emergency admissions, with a pooled post-implementation rate ratio of 0.77 (95% CI 0.60–0.97; P = .03). This effect emerged after several months consistent with progressive service penetration. Point estimates for secondary outcomes suggested reductions in ED attendances (rate ratio 0.79; 95% CI 0.61–1.02; P = .08) and length of stay (LOS) (ratio of means 0.68; 95% CI 0.50–0.92; P = .01). Conclusion Implementation of a geriatrician-led service was associated with a significant reduction in admissions and LOS, with point estimates also suggesting reductions in ED attendances. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
|---|