Abstract
Introduction:
Increasing prevalence of people living with frailty is a key challenge to healthcare providers. One solution may be virtual wards (VWs). Our research sought to: examine different frailty VW models; and determine how, why and under what circumstances VWs may work effectively.
During our early research, NHS England (NHSE) started roll-out of short-term VWs intended to treat acute patients with frailty crises at home instead of hospital. We expected our work to inform NHSE policy, especially how to ‘do’ VWs better.
Methods:
We conducted a rapid realist review of frailty VWs, searching published and grey literature for evidence on multidisciplinary VWs based in the UK, using a literature-based definition of VWs. Information on how and why VWs might ‘work’ was extracted and synthesised iteratively into context-mechanism-outcome configurations (CMOCs). Throughout we engaged closely with clinicians and patient/public contributors. The iterative nature of the realist review led to emerging understanding.
Results:
From 28 documents, we identified two VW models: longer-term, proactive care wards admitting patients at high risk of a frailty crisis; and short-term reactive care wards for people experiencing a frailty crisis. Using evidence from both models, we generated 12 CMOCs, under three themes.
First, building blocks for effective VW operation (e.g. common standards agreements, information sharing, a multidisciplinary team planning patient care remotely). Second, how the VW delivers the frailty pathway (e.g. patient selection, assessment, proactive care).
Third, Patient/Caregiver empowerment.
Mechanisms included motivating professionals (e.g. a ‘team-of-teams’); buy-in; building relationships: professionals, patients and caregivers.
VWs should be set within frailty management guidance, and a whole-system approach to care is needed. For sustainability of VWs, proactive care for people at high risk of a frailty crisis should be provided.
Conclusions:
This review has implications for optimal implementation and sustainability of frailty VWs, through proactive care and a whole system approach.
Increasing prevalence of people living with frailty is a key challenge to healthcare providers. One solution may be virtual wards (VWs). Our research sought to: examine different frailty VW models; and determine how, why and under what circumstances VWs may work effectively.
During our early research, NHS England (NHSE) started roll-out of short-term VWs intended to treat acute patients with frailty crises at home instead of hospital. We expected our work to inform NHSE policy, especially how to ‘do’ VWs better.
Methods:
We conducted a rapid realist review of frailty VWs, searching published and grey literature for evidence on multidisciplinary VWs based in the UK, using a literature-based definition of VWs. Information on how and why VWs might ‘work’ was extracted and synthesised iteratively into context-mechanism-outcome configurations (CMOCs). Throughout we engaged closely with clinicians and patient/public contributors. The iterative nature of the realist review led to emerging understanding.
Results:
From 28 documents, we identified two VW models: longer-term, proactive care wards admitting patients at high risk of a frailty crisis; and short-term reactive care wards for people experiencing a frailty crisis. Using evidence from both models, we generated 12 CMOCs, under three themes.
First, building blocks for effective VW operation (e.g. common standards agreements, information sharing, a multidisciplinary team planning patient care remotely). Second, how the VW delivers the frailty pathway (e.g. patient selection, assessment, proactive care).
Third, Patient/Caregiver empowerment.
Mechanisms included motivating professionals (e.g. a ‘team-of-teams’); buy-in; building relationships: professionals, patients and caregivers.
VWs should be set within frailty management guidance, and a whole-system approach to care is needed. For sustainability of VWs, proactive care for people at high risk of a frailty crisis should be provided.
Conclusions:
This review has implications for optimal implementation and sustainability of frailty VWs, through proactive care and a whole system approach.
| Original language | English |
|---|---|
| Pages | 2 |
| Number of pages | 1 |
| Publication status | Published - 22 Nov 2024 |
| Event | British Geriatrics Society Autumn Meeting 2024 - Excel, London, United Kingdom Duration: 20 Nov 2024 → 22 Nov 2024 https://www.bgs.org.uk/events/2024-autumn-meeting |
Conference
| Conference | British Geriatrics Society Autumn Meeting 2024 |
|---|---|
| Country/Territory | United Kingdom |
| City | London |
| Period | 20/11/24 → 22/11/24 |
| Internet address |
Bibliographical note
PLATFORM PRESENTATION: TECH IN GERIATRIC MEDICINE.2793. Scientific Presentation - Health Service Research.