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Understanding the models of community hospital rehabilitation activity (MoCHA): a mixed method study

Gladman, John; Buckell, John; Young, John; Smith, Andrew ; Hulme, Clare ; Saggu, Satti ; Godfrey, Mary ; Enderby, Pam ; Teale, Elizabeth ; Longo, Roberto ; Gannon, Brenda ; Holditch, Claire ; Eardley, Heather ; Tucker, Helen

Authors

John Gladman john.gladman@nottingham.ac.uk

John Buckell

John Young

Andrew Smith

Clare Hulme

Satti Saggu

Mary Godfrey

Pam Enderby

Elizabeth Teale

Roberto Longo

Brenda Gannon

Claire Holditch

Heather Eardley

Helen Tucker



Abstract

Introduction

To understand the variation in performance between community hospitals, our objectives are: to measure the relative performance (cost efficiency) of rehabilitation services in community hospitals; to identify the characteristics of community hospital rehabilitation that optimise performance; to investigate the current impact of community hospital in-patient rehabilitation for older people on secondary care and the potential impact if community hospital rehabilitation was optimised to best practice nationally; to examine the relationship between the configuration of intermediate care and secondary care bed use; and to develop toolkits for commissioners and community hospital providers to optimise performance.

Methods and analysis

Four linked studies will be performed.

Study 1: Cost efficiency modelling will apply econometric techniques to datasets from the NHS Benchmarking Network surveys of community hospital and intermediate care. This will identify community hospitals’ performance and estimate the gap between high and low performers. Analyses will determine the potential impact if the performance of all community hospitals nationally was optimised to best performance, and examine the association between community hospital configuration and secondary care bed use.

Study 2: A national community hospital survey gathering detailed cost data and efficiency variables will be performed.

Study 3: In-depth case studies of three community hospitals, two high and one low performing, will be undertaken. Case studies will gather routine hospital and local health economy data. Ward culture will be surveyed. Content and delivery of treatment will be observed. Patients and staff will be interviewed.

Study 4: Co-designed web-based quality improvement toolkits for commissioners and providers will be developed, including indicators of performance and the gap between local and best community hospitals performance. Ethics and dissemination Publications will be in peer reviewed journals, reports will be distributed through stakeholder organisations. Ethical approval was obtained from the Bradford Research Ethics committee (reference: 15/YH/0062).

Journal Article Type Article
Publication Date 2017-02
Journal BMJ Open
Electronic ISSN 2044-6055
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 7
Issue 2
Article Number e010483
APA6 Citation Gladman, J., Buckell, J., Young, J., Smith, A., Hulme, C., Saggu, S., …Tucker, H. (2017). Understanding the models of community hospital rehabilitation activity (MoCHA): a mixed method study. BMJ Open, 7(2), https://doi.org/10.1136/bmjopen-2015-010483
DOI https://doi.org/10.1136/bmjopen-2015-010483
Keywords Community hospitals; Mixed method research; Health economics; Geriatric medicine; Health services administration and management
Publisher URL http://bmjopen.bmj.com/content/7/2/e010483.info
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0





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