Nursing Studies

Supporting Community Recovery

Supporting Community Recovery and Reducing Readmission Risk Following Critical Illness (SCARF): development of programme theory, intervention development, trial design, and a realist evaluation for a subsequent multi-centre trial.

Around 8,000 patients survive an intensive care (ICU) admission in Scotland annually. However, survivors can sometimes experience ongoing problems after hospital discharge and 45-50% have an unplanned readmission within three months. We found ICU survivors describe recovery as a very individual journey, supporting the need for person-centred care which current services can struggle to provide as patients might need multiple or speciality services. At present, the NHS does not provide personalised support for these patients, despite their experiencing greater disability and ongoing needs than those with other diseases like stroke or cancer. The overall aim of this study is to develop and refine a complex health and social care pathway. This will lead to another project to evaluate the pathway we develop. 

We plan to develop a service model/pathway to firstly identify the highest risk patients early (at ICU discharge) and secondly support those identified using a complex intervention involving personalised health and social care in key domains identified from our earlier work. The intervention starts at ICU discharge and would likely run until the time of a follow-up visit at 2-3 months. The main goal is decreased unscheduled rehospitalisation (our recent work suggests these patients have a 50% readmission risk within 90 days).

We recently held two workshops with relevant stakeholders from all over the UK including both health and social care professionals and PPI representatives where we used a quality intervention framework to develop a programme theory of how this intervention will work. This will then underpin a UK multicentre study/trial grant application. We plan to submit to NIHR HS&DR next year.

 

Chief Investigator:

Prof. Timothy Walsh, Chair of Critical Care, University of Edinburgh

Co-investigators:

Dr. Sheila Rodgers (Nursing Studies, University of Edinburgh / Hon. Nurse Consultant in Critical Care, NHS Lothian) s.rodgers@ed.ac.uk

Dr. Eddie Donaghy (Research Fellow/Project Manager, Edinburgh Critical Care Research Group, University of Edinburgh) Eddie.Donaghy@ed.ac.uk

Dr. Susanne Kean (Nursing Studies, University of Edinburgh)

Prof. Aisha Holloway (Nursing Studies, University of Edinburgh)

Dr. Corrienne McCullough (Lead Research Nurse, Critical Care, NHS Lothian)

Dr. Nazir Lone (Usher Institute, University of Edinburgh)

Dr. Susan Shenkin (Geriatric Medicine, University of Edinburgh)

Dr. James Marple (Primary care, NHS Lothian)

Dr. Judith Merriweather (NHS Lothian)

Dr. Ruth Jepson (Scottish Collaboration for Public Health Research and Policy, University of Edinburgh)

Dr. Larry Doi (Scottish Collaboration for Public Health Research and Policy, University of Edinburgh)

Prof. Chris Weir (Usher Institute/Edinburgh Clinical Trials Unit (ECTU) University of Edinburgh)

Dr. Peter Hall (Usher Institute/Edinburgh Clinical Trials Unit (ECTU) University of Edinburgh)