Enhancing healthcare at home for older people in rural and regional Australia: A protocol for co-creation to design and implement system change

Cindy Needham; Nikita Wheaton; Anna Wong Shee; Kevin McNamara; Mary Malakellis; Margaret Murray; Laura Alston; Anna Peeters; Anna Ugalde; Catherine Huggins; Serene Yoong; Steven Allender

doi:10.1371/journal.pone.0290386

Enhancing healthcare at home for older people in rural and regional Australia: A protocol for co-creation to design and implement system change

PLoS One. 2023 Sep 8;18(9):e0290386. doi: 10.1371/journal.pone.0290386. eCollection 2023.

Authors

Affiliations

¹ Institute for Health Transformation, Global Centre for Preventative Health and Nutrition, School of Health and Social Development Faculty of Health, Deakin University, Geelong, Australia.
² Deakin Rural Health, School of Medicine, Faculty of Health, Deakin University, Geelong, Australia.
³ Community and Aged Care, Grampians Health, Ballarat, Victoria, Australia.
⁴ Research Unit, Colac Area Health, Colac, Victoria, Australia.
⁵ Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Australia.

Abstract

Background: World-wide, health service providers are moving towards innovative models of clinical home-based care services as a key strategy to improve equity of access and quality of care. To optimise existing and new clinical home-based care programs, evidence informed approaches are needed that consider the complexity of the health care system across different contexts.

Methods: We present a protocol for working with health services and their partners to perform rapid identification, prioritisation, and co-design of content-appropriate strategies to optimise the delivery of healthcare at home for older people in rural and regional areas. The protocol combines Systems Thinking and Implementation Science using a Consensus Mapping and Co-design (CMC) process delivered over five workshops.

Discussion: The protocol will be implemented with rural and regional healthcare providers to identify digital and non-digital solutions that have the potential to inform models of service delivery, improve patient experience, and optimise health outcomes. The combination of system and implementation science is a unique approach for optimising healthcare at home for older populations, especially in the rural context where need is high. This is the first protocol to integrate the use of systems and implementation science into one process and articulating these methods will help with replicating this in future practice. Results of the design phase will translate into practice through standard health service planning methods to enhance implementation and sustainability. The delivery of the protocol will include building capacity of health service workers to embed the design, implementation, and evaluation approach into normal practice. This protocol forms part of the DELIVER (Delivering Enhanced heaLthcare at home through optImising Virtual tools for oldEr people in Rural and regional Australia) Project. Funded by Australia's Medical Research Future Fund, DELIVER involves a collaboration with public health services of Western Victoria, Australia.

Copyright: © 2023 Needham et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Biomedical Research*
Consensus
Health Facilities*
Health Workforce
Humans
Victoria

Grants and funding

The DELIVER research program was supported by an Australian Commonwealth Government funded Medical Research Futures Fund, Rapid Applied Research Translation Grant (RARUR000072). The funding body has had no input into the study design, decision to publish or preparation of the manuscript. AU is supported by a Victorian Cancer Agency Early Career Health Services Research Fellowship. AP is supported by an National Health and Medical Research Centre fellowship. SY is supported by a Heart Foundation Future Leader Fellowship (106654). LA, AWS, NW as part of Deakin Rural Health are supported by the Australian Government funded Rural Health Multidisciplinary Programme. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.