Evaluation of a Residential In-Reach Program in Regional and Rural Australia

Residential In-Reach (RIR) programs are designed to provide responsive care for residents in residential aged care homes (RACH) with the aim of avoiding unnecessary hospital transfers. The evidence for their clinical and cost-effectiveness and implementation has been established in urban settings, but there is a small amount of low-quality evidence for rural and regional settings. The Grampians Region Health Service Partnership Resi-In-Reach Redesign Committee will be implementing a new RIR program to be offered to all RACHs in the Grampians region, this project aims to evaluate the clinical and cost-effectiveness of this program, and its implementation in the rural and regional setting. A stepped-wedge trial will be conducted so that as the RIR program is gradually rolled-out across the region, outcomes can be compared in the same facilities across time and between different facilities. The primary outcome measure will be presentation to emergency departments and urgent care centres, and data will also be collected on other clinical outcomes and barriers and enablers of implementing the program. It is anticipated that there will be a reduction in hospital presentations, and a range of barriers and enablers unique to the rural and regional setting will emerge.

Inclusion Criteria: * Health services that have emergency departments and/or emergency care centres that admit residents from residential aged care homes (RACH) * RACHs that do not currently have access to RIR programs * health service staff who have been involved with the set-up and delivery of the RIR program, * RACH staff who have experience of or accessing the RIR service for residents at least once, * residents living at a RACH who has experienced receiving medical care from the RIR program and can provide informed consent, or a family member of the resident, * general practitioners whose case load includes residents from RACHs. Exclusion Criteria: • RACHs that already have access to a RIR program will be excluded