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INSPIRE: Implementation of an integrated community-based care program for home-dwelling senior citizens

Applicant De Geest Sabina
Number 183427
Funding scheme NRP 74 Smarter Health Care
Research institution Institut für Pflegewissenschaft Universität Basel
Institution of higher education University of Basel - BS
Main discipline Public Health and Health Services
Start/End 01.02.2019 - 31.12.2022
Approved amount 461'266.00
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All Disciplines (2)

Discipline
Public Health and Health Services
Geriatrics

Keywords (7)

nursing; multimorbidity; implementation science; home care; models of care; integrated care; geriatrics

Lay Summary (German)

Lead
In Kanton Basel-Landschaft (BL) wurde die Organisation der Gesundheitsversorgung älterer Menschen überdacht. Die neue Gesetzgebung (ab 1.1.2018) schreibt eine Reorganisation des Kantons in Versorgungsregionen mit Informations- und Beratungsstellen vor. INSPIRE baut auf dieser Gesetzgebung auf und unterstützt die Entwicklung, Durchführung und Evaluation eines neuen pflegegeleiteten integrierten Versorgungsmodells für zu Hause lebende ältere Menschen.
Lay summary

Inhalt und Ziele des Forschungsprojekts

Obwohl die Mehrheit der älteren Menschen am liebsten, so lange wie möglich zu Hause zu bleiben, besteht bei einem Drittel das Risiko aufgrund funktionaler Einschränkungen dieses Ziel nicht zu erreichen. Ältere Menschen brauchen oft eine Kombination von Dienstleistungen, die bis jetzt weder zentralisiert noch koordiniert sind. Die Versorgung ist daher oft fragmentiert. Ältere Menschen bekommen dadurch nicht immer eine optimale Versorgung. Integrierte Versorgungsmodelle sind daher gefragt.

Das Ziel von INSPIRE besteht darin, ein pflegegeleitetes integriertes Versorgungsmodell für ältere Menschen mit Multimorbidität, welche zu Hause leben, zu entwickeln, zu implementieren und zu evaluieren. INSPIRE ist ein Implementationsforschungsprojekt. Elemente wie zum Beispiel Stakeholder Involvierung, Kontextanalyse, und Gebrauch von Implementationsstrategien sind ebenso wichtig wie die Evaluierung der Effektivität. Im gesamten Kanton Basel-Landschaft werden mehrmals Befragungen der älteren Bevölkerung durchgeführt, mit dem Ziel Charakteristiken und Präferenzen in Basel-Landschaft zu Hause lebenden älteren Menschen zu erfassen. Die INSPIRE Intervention wird in zwei Versorgungsregionen in Basel-Landschaft implementiert und evaluiert.

Wissenschaftlicher und gesellschaftlicher Kontext des Forschungsprojekts

Das INSPIRE Versorgungsmodell könnte sehr relevant sein für andere Gesundheitssysteme, die mit ähnlichen Herausforderungen in der Versorgung älterer zu Hause lebender Menschen konfrontiert sind.

Direct link to Lay Summary Last update: 06.12.2018

Responsible applicant and co-applicants

Employees

Project partner

Publications

Publication
Core components and impact of nurse-led integrated care models for home-dwelling older people: A systematic review and meta-analysis
Deschodt Mieke, Laurent Gwen, Cornelissen Lonne, Yip Olivia, Zúñiga Franziska, Denhaerynck Kris, Briel Matthias, Karabegovic Azra, De Geest Sabina (2020), Core components and impact of nurse-led integrated care models for home-dwelling older people: A systematic review and meta-analysis, in International Journal of Nursing Studies, 105, 103552-103552.

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
Annual Meeting of the American Geriatrics Society Poster Core components and impact of nurse-led integrated care models for home-dwelling older people: a systematic review and meta-analysis. 06.05.2020 Long Beach, CA, United States of America Deschodt Mieke;
5th Annual SPINE Doctoral Research Day Poster Developing an integrated care model for frail older adults using a logic model and implementation science methods. 06.11.2019 Basel, Switzerland Zeller Andreas; De Geest Sabina; Stenz Samuel; Deschodt Mieke;
5th Annual SPINE Doctoral Research Day Poster Living preferences and health care utilization of home-dwelling older people in Canton Basel-Landschaft. 06.11.2019 Basel, Switzerland De Geest Sabina; Deschodt Mieke; Probst-Hensch Nicole; Stenz Samuel;
International Jerusalem Conference on Health Policy Talk given at a conference Implementation of an integrated nurse-led care program for community-dwelling older adults in Canton Baselland: the INSPIRE project. 15.09.2019 Jerusalem, Israel Zeller Andreas; Deschodt Mieke; Briel Matthias; Schwenkglenks Matthias; De Geest Sabina; Probst-Hensch Nicole;


Knowledge transfer events

Active participation

Title Type of contribution Date Place Persons involved
Driving Innovation and Implementation in Interprofessional Health Care Delivery Talk 31.01.2020 Basel, Switzerland Deschodt Mieke;
Uni am Markt Gelterkinden Talk 09.10.2019 Gelterkinden, Switzerland Deschodt Mieke; Stenz Samuel;
Uni am Markt Laufen Talk 01.10.2019 Laufen, Switzerland Deschodt Mieke; Stenz Samuel;
Uni am Markt Reigoldswil Talk 28.09.2019 Reigoldswil, Switzerland Deschodt Mieke; Stenz Samuel;
UniTalk Talk 26.09.2019 Laufen, Switzerland Stenz Samuel; Deschodt Mieke; De Geest Sabina;
Uni am Markt Liestal Talk 25.09.2019 Liestal, Switzerland Deschodt Mieke; Stenz Samuel;
Plattform Alter Talk 06.04.2019 Bottmingen, Switzerland Stenz Samuel;
DayOne Initiative BaselAreaSwiss - Ageing: the game changer of healthcare Talk 26.02.2019 Basel, Switzerland Deschodt Mieke;


Self-organised

Title Date Place
5th Cantonal stakeholder meeting 15.10.2019 Liestal, Switzerland
4th Cantonal stakeholder meeting 26.03.2019 Liestal, Switzerland

Communication with the public

Communication Title Media Place Year
Video/Film INSPIRE International 2020
Media relations: print media, online media «Lesbarkeit ist mit grossen Buchstaben garantiert» – Uni Basel untersucht Bedürfnisse älterer Mensch German-speaking Switzerland 2019
Talks/events/exhibitions 4th Cantonal stakeholder meeting German-speaking Switzerland 2019
Talks/events/exhibitions 5th Cantonal stakeholder meeting German-speaking Switzerland 2019
Media relations: print media, online media Bevölkerungsbefragung für Senioren und Seniorinnen im Kanton Basel-Landschaft. Allschwiler Wochenblatte German-speaking Switzerland 2019
Media relations: print media, online media Das Baselbiet wird zum Altersheim der Schweiz Prime News German-speaking Switzerland 2019
Talks/events/exhibitions Driving Innovation and Implementation in Interprofessional Health Care Delivery - Institute for Nurs German-speaking Switzerland 2019
Media relations: print media, online media Fragwürdiger Fragebogen: Uni Basel gerät wegen Umfrage unter Druck Basellandschaftliche Zeitung German-speaking Switzerland 2019
Media relations: print media, online media Graue Panther fordern Datenschutz – und raten vorerst vom Fragebogen der Uni Basel ab Basellandschaftliche Zeitung German-speaking Switzerland 2019
Talks/events/exhibitions Plattform Alter German-speaking Switzerland 2019
Media relations: print media, online media Sich von einem Roboter pflegen lassen? Baselbieter Senioren würden's zulassen Basellandschaftliche Zeitung German-speaking Switzerland 2019
Media relations: print media, online media Umfangreiche Befragung von älteren Menschen in Baselland. UniNews Universität Basel, German-speaking Switzerland 2019
Talks/events/exhibitions Uni am Markt Gelterkinden German-speaking Switzerland 2019
Talks/events/exhibitions Uni am Markt Laufen German-speaking Switzerland 2019
Talks/events/exhibitions Uni am Markt Liestal German-speaking Switzerland 2019
Talks/events/exhibitions Uni am Markt Reigoldswil German-speaking Switzerland 2019
Media relations: print media, online media Uni Basel reagiert auf Kritik – detaillierter Fragebogen an Senioren wird vollst Basellandschaftliche Zeitung German-speaking Switzerland 2019
Media relations: print media, online media Uni-Befragung für Senioren. Basler Zeitung German-speaking Switzerland 2019
Talks/events/exhibitions UniTalk Laufen German-speaking Switzerland 2019

Associated projects

Number Title Start Funding scheme
198082 Towards implementation of an evidence-based approach in clinical research 01.02.2021 COST (European Cooperation in Science and Technology)

Abstract

Although the majority of the older people prefers to remain in their homes and community for as long as possible, approximately one third of home-dwelling older people are at risk for not being able to age in place due to functional limitations. To allow older people to age in their homes despite functional dependencies, a strong long-term care system is needed. Long-term care for older people, often suffering from multiple chronic health problems and disability is however often provided by a large number of care providers and care across these providers is often neither centralized nor coordinated, putting older people at risk for fragmented care. This leads to duplication of services, gaps in information delivery, and inappropriate or conflicting care recommendations and inevitably leads to medication errors, confusion and distress for older people and their caregivers, but also to higher care costs due to unnecessary hospitalizations and other unnecessary use of services. The overall aim of INSPIRE (Implementation of an integrated community-based care program for home-dwelling senior citizens), is to implement and evaluate a nurse-led integrated model of care for home-dwelling older people with multimorbidity in Canton Basel-Landschaft (Canton BL). More specifically, in INSPIRE we will, first, assess the prevalence of multi-morbid older people living at home and their risk for hospitalization or institutionalization and assess the change in hospitalization rate, nursing home admission rate and health-related quality of life over time in the whole Canton of BL by means of repeated cross-sectional survey design: Second, we will evaluate the feasibility, acceptability, and impact of the INSPIRE program on hospital and nursing home admission rates, utilization of home care and community care services use, health-related quality of life, caregiver burden, and satisfaction of home-dwelling multi-morbid older people and their informal caregivers by means of two prospective patient cohort studies. Third, we will estimate the geographical distribution of disease-specific mortality, morbidity and disability in home-dwelling older people across the canton and project the older population’s associated morbidity, mortality and disability in the next 10 years. INSPIRE combines implementation science methods and public health methodologies (i.e. population surveys, patient cohorts, spatiotemporal analyses) with the goal to bring true change in the real world in view of the implementation of an effective and sustainable integrated community-based care program for senior citizens in Canton Baselland. INSPIRE has the potential to provide a blueprint for contextually adapted community-based care models for home-dwelling older people in Switzerland and beyond. Although health care budgets will continue to increase, integrated community care based models such as INSPIRE, that have the potential to postpone or avoid hospitalizations and institutionalization and to optimize adequate investment of resources for the care of community-dwelling older people, can contribute to a less steep increase of the health care budget in coming years.
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