Clinical Assessment and Treatment in the Nursing Home as an Alternative to Hospital Admission

Summary

This multicenter, cluster-randomized, unblinded quality-improvement study evaluates whether home-based clinical assessment by municipal acute care teams can safely reduce hospital admissions among nursing home residents experiencing acute illness or clinical deterioration during out-of-hours periods. Participating nursing homes in the Capital Region of Denmark will be randomized to either usual care (contacting the regional medical helpline, 1813) or the intervention pathway, in which nursing home staff contact a municipal acute care team directly. The acute care team performs an on-site clinical assessment and, when needed, consults a senior physician in the hospital emergency department to establish a treatment and observation plan, which may include continued management at the nursing home under hospital responsibility. The study compares the intervention with usual care with respect to hospital admissions and mortality among nursing home residents.

Conditions

• Nursing Homes Residents
• Deterioration, Clinical
• Infection
• Dehydration
• Pain Management

Interventions

OTHER

Home-based Clinical Assessment and Treatment

Nursing homes in the intervention group will, if a resident experiences acute illness or clinical deterioration, call the municipal acute care team directly. They will then do a home-based clinical assessment and, if deemed necessary, consult a senior physician in the hospital emergency or geriatrics department to establish a treatment and observation plan.

Sponsors & Collaborators

• Herlev and Gentofte Hospital

  collaborator OTHER

• Amager Hospital

  collaborator OTHER

• Bispebjerg Hospital

  collaborator OTHER

• Nordsjaellands Hospital

  collaborator OTHER

• Copenhagen University Hospital at Herlev

  lead OTHER

Principal Investigators

• Kasper K Iversen, MD, Professor · University Hospital of Copenhagen Herlev and Gentofte

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-02-01

Primary Completion

2027-06-30

Completion

2027-12-31

Countries

• Denmark

Study Locations