Grant: Planning and Dissemination Grant - Institute Community Support

Home care clients are a large and medically complex subgroup of community-dwelling seniors. Canadian estimates suggest that home care clients have double the ED utilization rate compared to nursing home residents and other community dwelling seniors. Evidence to support best practices in ED prevention is limited, so home care agencies must make decisions based on incomplete information. Also, home care agencies often do not have the capacity to evaluate their programs in a timely manner or using validated methods. Risk targeting mechanisms combined with rigorous randomized evaluations have the potential to expand knowledge on effective ED avoidance programs. Building on previous work, we propose to organize a provincial network - the DIVERT Home Care Network - that will carry out clinical initiatives and evaluation aimed understanding what type and intensity of home care services should be offered to reduce unplanned ED visits. This planning proposal seeks to convene a group of home care key informants as well as scientists for a full day consensus workshop in Janurary 2015 at the Institute for Clinical Evaluative Sciences (Toronto). The network will evaluate local interventions of promising interventions aimed at reducing avoidable ED use. The main goal the DIVERT Home Care Network workshop will be to establish direction for a CIHR Operating proposal for a multi-site evaluation of ED avoidance programs across a number of jurisdictions. Also, work on a preparatory environmental scan and baseline data report will also be published. Publication of the planning workshop materials and subsequent research activities will expand the knowledge base on ED avoidance programs originating in home care.