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The Optimal Study: describing the key components of optimal health care delivery to UK care home residents: a research protocol

Gordon, Adam L.; Goodman, Claire; Dening, Tom; Davies, Sue; Gladman, John R.F.; Bell, Brian G.; Zubair, Maria; Handley, Melanie J.; Meyer, Julienne; Bowman, Clive; Gage, Heather; Iliffe, Steve R.; Martin, Finbarr C.; Schneider, Justine; Victor, Christina


Professor of The Care of Older People

Claire Goodman

Clinical Professor in Dementia Research

Sue Davies

Professor of Medicine of Older People

Brian G. Bell

Maria Zubair

Melanie J. Handley

Julienne Meyer

Clive Bowman

Heather Gage

Steve R. Iliffe

Finbarr C. Martin

Professor of Mental Health & Social Care

Christina Victor


Long term institutional care in the UK is provided by care homes. Residents have prevalent cognitive impairment and disability, have multiple diagnoses and are subject to polypharmacy. Prevailing models of healthcare provision - ad hoc, reactive and co-ordinated by general practitioners - result in unacceptable variability of care. A number of innovative responses to improve health care for care homes have been commissioned. The organisation of health and social care in the UK is such that it is unlikely that a single solution to the problem of providing quality healthcare for care homes will be identified that can be used nationwide.
Realist evaluation is a methodology which uses both qualitative and quantitative data to establish an in depth understanding of what works, for whom, in what settings. In this paper we describe a protocol for using realist evaluation to understand the context, mechanisms and outcomes which shape effective health care delivery to care home residents in the UK. By describing this novel approach, we hope to inform international discourse about research methodologies in long-term care settings internationally.


Gordon, A. L., Goodman, C., Dening, T., Davies, S., Gladman, J. R., Bell, B. G., …Victor, C. (2014). The Optimal Study: describing the key components of optimal health care delivery to UK care home residents: a research protocol. Journal of the American Medical Directors Association, 15(9),

Journal Article Type Article
Acceptance Date Apr 1, 2014
Publication Date Jul 30, 2014
Deposit Date Mar 21, 2017
Publicly Available Date Mar 21, 2017
Journal Journal of the American Medical Directors Association
Print ISSN 1525-8610
Electronic ISSN 1538-9375
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 15
Issue 9
Keywords Nursing homes, homes for the aged, delivery of health care, frail older adults, research design
Public URL
Publisher URL


The Optimal Studey AAM.pdf (662 Kb)

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