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Implementing a bundle of interventions to support older adults transitioning from hospital to residential aged care: a protocol for the process evaluation of the OPTIMAL stepped wedge cluster randomised controlled trial

Title: Implementing a bundle of interventions to support older adults transitioning from hospital to residential aged care: a protocol for the process evaluation of the OPTIMAL stepped wedge cluster randomised controlled trial
Authors: Gillian Harvey; Alice Bourke; Maria Crotty; Craig Whitehead; Maria C Inacio; Rangika L Fernando; John Forward; Chloe Furst; Ishita Batta; Sandra Shaw; Luke Shepperd
Source: BMJ Open, Vol 16, Iss 2 (2026)
Publisher Information: BMJ Publishing Group
Publication Year: 2026
Collection: Directory of Open Access Journals: DOAJ Articles
Subject Terms: Medicine
Description: Introduction The Optimising older People’s Transition from acute care Into residential aged care through Multidisciplinary Assessment and Liaison (OPTIMAL) trial is a multisite hybrid type II stepped wedge randomised controlled trial with an embedded process evaluation that aims to evaluate the effectiveness of implementing a bundle of evidence-based interventions to provide systematic support to older adults being discharged from hospital to residential aged care (RAC) homes for the first time. The trial is based on evidence from models of care used internationally to improve the quality of care transitions and addresses a need to provide evidence of transferability and effectiveness of these models in the Australian context. The embedded process evaluation will assess the acceptability, appropriateness, feasibility, adoption and fidelity of the OPTIMAL intervention, as well as the mechanisms of impact.Methods and analysis The OPTIMAL trial will be implemented across the three metropolitan local health networks (LHNs) in South Australia. The process evaluation will be conducted in parallel with the main trial and is theoretically informed by the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) implementation framework, which theorises that the implementation success of OPTIMAL is determined by the facilitation of the intervention with the intended recipients in their inner and outer contextual setting. The process evaluation will employ a mixed methods approach. Qualitative and quantitative data will be collected through baseline context mapping of LHNs, interviews with key LHN and RAC stakeholders, online survey of clinical teams, fortnightly check-in forms, and activity logs and field notes maintained by the nurse facilitator in each LHN. Data will be mapped and reported based on the i-PARIHS framework.Ethics and dissemination Ethical approval for the OPTIMAL trial was obtained from the Southern Adelaide Clinical Human Research Ethics Committee (approval 2023/HRE00111), and ...
Document Type: article in journal/newspaper
Language: English
Relation: https://bmjopen.bmj.com/content/16/2/e106443.full; https://doaj.org/toc/2044-6055; https://doaj.org/article/aca01fc5e20b4b58b1893e3e1d7f947b
DOI: 10.1136/bmjopen-2025-106443
Availability: https://doi.org/10.1136/bmjopen-2025-106443; https://doaj.org/article/aca01fc5e20b4b58b1893e3e1d7f947b
Accession Number: edsbas.15343300
Database: BASE