Article type
Abstract
"Background
Age-related frailty is becoming a global public health priority. People with frailty risk unpredictable health deterioration and can ‘tip’ into a crisis after a minor event, resulting in acute hospital admissions and pressure on health services.
The UK National Health Service England (NHSE) recently tasked local health and care systems with introducing ‘virtual wards’ nationwide, aiming to treat patients with frailty crises at home instead of hospital.
We conducted a rapid realist review - started before NHSE guidance was issued - seeking to inform service planning in a high-profile area.
Objectives
Identify virtual ward models in operation. Understand how, why and in which contexts virtual wards may work effectively and sustainably. Translate the findings to inform evidence-based policy and disseminate the knowledge.
Methods
We conducted a rapid realist review, taking a broad and inclusive perspective. We identified and compared virtual ward models, and synthesised the evidence into programme theories, describing components that combine to make virtual wards ‘work’ and important mechanisms and factors. We worked closely with clinicians and patient/public contributors, drew implications for practice and published an article in an important relevant journal.
Alongside clinician team members, we disseminated findings early because of their topical relevance to NHSE roll-out of virtual wards: publishing a preprint, and giving a webinar to a virtual wards group within a regional NHSE organisation. Before journal publication, we developed a policy briefing, press releases and other communications, consulting stakeholders and revising accordingly.
Results
Iterations of the realist synthesis, stakeholder involvement, and views and experiences from the webinar enabled greater understanding of the factors important to operationalising virtual wards and empowering patients/caregivers. This knowledge was incorporated in our policy briefing and press release, and led to emerging findings and recommendations relevant to the roll-out of NHSE virtual wards, particularly around the potential value of a combination of virtual ward models and the need for a preventative and whole system approach.
Conclusion
Findings from a rapid realist review and its knowledge dissemination can potentially influence UK policy on virtual wards. We will share lessons learnt and report how our knowledge dissemination impacted on policy."
Age-related frailty is becoming a global public health priority. People with frailty risk unpredictable health deterioration and can ‘tip’ into a crisis after a minor event, resulting in acute hospital admissions and pressure on health services.
The UK National Health Service England (NHSE) recently tasked local health and care systems with introducing ‘virtual wards’ nationwide, aiming to treat patients with frailty crises at home instead of hospital.
We conducted a rapid realist review - started before NHSE guidance was issued - seeking to inform service planning in a high-profile area.
Objectives
Identify virtual ward models in operation. Understand how, why and in which contexts virtual wards may work effectively and sustainably. Translate the findings to inform evidence-based policy and disseminate the knowledge.
Methods
We conducted a rapid realist review, taking a broad and inclusive perspective. We identified and compared virtual ward models, and synthesised the evidence into programme theories, describing components that combine to make virtual wards ‘work’ and important mechanisms and factors. We worked closely with clinicians and patient/public contributors, drew implications for practice and published an article in an important relevant journal.
Alongside clinician team members, we disseminated findings early because of their topical relevance to NHSE roll-out of virtual wards: publishing a preprint, and giving a webinar to a virtual wards group within a regional NHSE organisation. Before journal publication, we developed a policy briefing, press releases and other communications, consulting stakeholders and revising accordingly.
Results
Iterations of the realist synthesis, stakeholder involvement, and views and experiences from the webinar enabled greater understanding of the factors important to operationalising virtual wards and empowering patients/caregivers. This knowledge was incorporated in our policy briefing and press release, and led to emerging findings and recommendations relevant to the roll-out of NHSE virtual wards, particularly around the potential value of a combination of virtual ward models and the need for a preventative and whole system approach.
Conclusion
Findings from a rapid realist review and its knowledge dissemination can potentially influence UK policy on virtual wards. We will share lessons learnt and report how our knowledge dissemination impacted on policy."