Development and pilot-testing of RATHER-NH – an innovative complex intervention to Reduce Avoidable Transitions between Hospital or Emergency Room and Nursing Home

Project Details


A growing number of frail older people living in nursing homes (NHs)
remain at risk of hospitalisations, which can be detrimental for them
and their families and is related to high societal costs. While some
hospitalisation is necessary and appropriate, about 67% of
hospitalisations of NH residents are considered potentially avoidable
and unnecessary. Yet, there remains a lack of strong evidence on
effective interventions that could reduce potentially avoidable
hospitalisations (PAH) of NH residents and could be implemented
and embedded successfully into daily practice in NHs. Hence, we
aim to develop and pilot test RATHER-NH, an innovative complex
intervention that could reduce PAH from NHs and could be
implemented and embedded successfully into daily NH practice.
First, we will develop RATHER-NH and its implementation guidance
by building on existing evidence, using an iterative process involving
key stakeholders – at the levels of residents, families, health and
social care professionals working in NHs, NH organisation and health
services and systems, and paying attention to implementation in the
real world using a novel implementation science theory (Extended
Normalization Process Theory).
Second, we will test the preliminary effectiveness of RATHER-NH in
reducing PAH from NHs and assess its implementation using
multiple research methods, including the use of routinely-collected
nationwide administrative databases to collect data on residents and
intervention outcomes..
Effective start/end date1/01/2231/12/25


  • intervention research
  • hospitalisations
  • nursing homes

Flemish discipline codes in use since 2023

  • Residential health care
  • Elderly care
  • Palliative care and end-of-life care
  • Geriatric nursing


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