title: A complex intervention to support 'rest home' care: a pilot study.
abstract: OBJECTIVE
  To describe an intervention supporting Aged Related Residential Care (ARRC) and to report an initial evaluation.
  
  
  METHODS
  The intervention consisted of: medication review by a multidisciplinary team; education programmes for nurses; telephone advice 'hotlines' for nursing and medical staff; Advance Care Planning; and implementing existing community programmes for chronic care management and preventing acute hospital admissions. Semi-structured interviews were conducted with members of the multidisciplinary team, rest home nurses and caregivers. Quantitative data were collected on medication changes, hotline use, use of education opportunities and admissions to hospital.
  
  
  RESULTS
  Medications were reduced by 21%. Staff noted improvements in the physical and mental state of residents. There was no significant reduction in hospital admissions. Nurses were unable to attend the education offered to them, but it was taken up and valued by caregivers. There was minimal uptake of formal acute and chronic care programmes and Advance Care Planning during the intervention. Hotlines were welcomed and used regularly by the nurses, but not the GP.
  
  
  CONCLUSIONS
  The provision of high status specialist support on site was enthusiastically welcomed by ARRC staff. The interventions continue to evolve due to limited uptake or success of some components in the pilot.
authors.affiliation: Counties Manukau District Heath Board, South Auckland, New Zealand.
authors.forename: Shankar
authors.initials: S
authors.lastname: Sankaran
authors.forename: Tim
authors.initials: T
authors.lastname: Kenealy
authors.forename: Allan
authors.initials: A
authors.lastname: Adair
authors.forename: Vivienne
authors.initials: V
authors.lastname: Adair
authors.forename: Heather
authors.initials: H
authors.lastname: Coster
authors.forename: Noeline
authors.initials: N
authors.lastname: Whitehead
authors.forename: Nicolette
authors.initials: N
authors.lastname: Sheridan
authors.forename: Matthew
authors.initials: M
authors.lastname: Parsons
authors.forename: Elaine
authors.initials: E
authors.lastname: Marshall
authors.forename: Leslie
authors.initials: L
authors.lastname: Bailey
authors.forename: Catherine
authors.initials: C
authors.lastname: Price
authors.forename: Dwayne
authors.initials: D
authors.lastname: Crombie
authors.forename: Harry
authors.initials: H
authors.lastname: Rea
mesh_terms: D032722:Advance Care Planning; D000368:Aged; D000369:Aged, 80 and over; D003153:Community Health Services / Q000379:methods; D017723:Drug Utilization Review / Q000379:methods; D004509:Education, Nursing, Continuing / Q000379:methods; D005853:Geriatrics / Q000379:methods; D018166:Health Care Reform / Q000379:methods*; D006707:Homes for the Aged / Q000458:organization & administration*; D015277:Hotlines; D006801:Humans; D009520:New Zealand; D010343:Patient Admission / Q000706:statistics & numerical data; D010348:Patient Care Team; D010865:Pilot Projects; D015397:Program Evaluation / Q000379:methods*