Background
Aims and objectives
-
To explore components, practices and experiences of CGA in HAH and inpatient settings
-
To describe key elements of trial contexts and explore how these might affect implementation of the intervention and of the RCT
-
To identify unanticipated consequences and aspects of the trial that are not necessarily captured quantitatively
Methods
Setting
Domain | Focus |
---|---|
Context | • Outer setting: what is the local, regional and national context? How may social, political and economic contexts influence implementation? • Inner setting: how do organisational and service structures, cultures and relationships influence implementation? |
Implementation | • What are the characteristics of those delivering and receiving the intervention in HAH and inpatient settings? • What are the intervention characteristics and processes of implementation in each setting, and how do these relate to the experiences and engagement of patients and caregivers? • How do these aspects of implementation relate to the existing programme theory and logic model for CGA (Fig. 2)? |
Recruitment | • How are individuals recruited and by whom? • Are those recruited to the RCT representative of the overall ‘real world’ target population? • How do RCT implementation processes differ across settings? • How are RCT processes sustained or threatened over time? • Are there unintended consequences in processes and outcomes related to involvement in RCT, to the intervention or to other aspects of care? |
Design
Existing theory and objectives underlying the complex intervention
Process evaluation questions
Generating data
Interview processes
-
Participants’ accounts of their presenting event and means of accessing acute healthcare
-
Perceptions of interactions with healthcare professionals and other staff throughout the trajectory of service input for their presenting episode, from assessment to discharge and any follow-up received
-
Whether any documentation was provided to patients and caregivers and, if so, how they perceived and used this (e.g. service information leaflets, goal sheets, medication information, discharge letters)
-
How patients understood the intervention or other measures to have contributed to recovery from their presenting event and their ability to continue to manage after discharge
-
Caregivers’ perceptions of positive and negative aspects of the healthcare experience and how effectively they perceived the patient’s and their own needs to have been addressed
-
How and where they received input from healthcare services, and how healthcare professionals communicated or discussed transitions with them