Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/23109
Appears in Collections:Faculty of Social Sciences Journal Articles
Peer Review Status: Refereed
Title: Support and Assessment for Fall Emergency Referrals (SAFER 1) trial protocol. Computerised on-scene decision support for emergency ambulance staff to assess and plan care for older people who have fallen: Evaluation of costs and benefits using a pragmatic cluster randomised trial
Authors: Snooks, Helen
Cheung, Wai-Yee
Close, Jacqueline
Dale, Jeremy
Gaze, Sarah
Humphreys, Ioan
Lyons, Ronan
Mason, Suzanne
Merali, Yasmin
Peconi, Julie
Phillips, Ceri
Phillips, Judith
Roberts, Stephen
Russell, Ian
Sanchez, Antonio
Contact Email: judith.phillips@stir.ac.uk
Issue Date: 26-Jan-2010
Publisher: BioMed Central
Citation: Snooks H, Cheung W, Close J, Dale J, Gaze S, Humphreys I, Lyons R, Mason S, Merali Y, Peconi J, Phillips C, Phillips J, Roberts S, Russell I & Sanchez A (2010) Support and Assessment for Fall Emergency Referrals (SAFER 1) trial protocol. Computerised on-scene decision support for emergency ambulance staff to assess and plan care for older people who have fallen: Evaluation of costs and benefits using a pragmatic cluster randomised trial, BMC Emergency Medicine, 10 (1), Art. No.: 2.
Abstract: Background Many emergency ambulance calls are for older people who have fallen. As half of them are left at home, a community-based response may often be more appropriate than hospital attendance. The SAFER 1 trial will assess the costs and benefits of a new healthcare technology - hand-held computers with computerised clinical decision support (CCDS) software - to help paramedics decide who needs hospital attendance, and who can be safely left at home with referral to community falls services.  Methods/Design  Pragmatic cluster randomised trial with a qualitative component. We shall allocate 72 paramedics ('clusters') at random between receiving the intervention and a control group delivering care as usual, of whom we expect 60 to complete the trial.  Patients are eligible if they are aged 65 or older, live in the study area but not in residential care, and are attended by a study paramedic following an emergency call for a fall. Seven to 10 days after the index fall we shall offer patients the opportunity to opt out of further follow up. Continuing participants will receive questionnaires after one and 6 months, and we shall monitor their routine clinical data for 6 months. We shall interview 20 of these patients in depth. We shall conduct focus groups or semi-structured interviews with paramedics and other stakeholders.  The primary outcome is the interval to the first subsequent reported fall (or death). We shall analyse this and other measures of outcome, process and cost by 'intention to treat'. We shall analyse qualitative data thematically.  Discussion  Since the SAFER 1 trial received funding in August 2006, implementation has come to terms with ambulance service reorganisation and a new national electronic patient record in England. In response to these hurdles the research team has adapted the research design, including aspects of the intervention, to meet the needs of the ambulance services.  In conclusion this complex emergency care trial will provide rigorous evidence on the clinical and cost effectiveness of CCDS for paramedics in the care of older people who have fallen.
Type: Journal Article
URI: http://hdl.handle.net/1893/23109
DOI Link: http://dx.doi.org/10.1186/1471-227X-10-2
Rights: © 2010 Snooks et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Notes: Additional co-authors: Mushtaq Wani, Bridget Wells and Richard Whitfield
Affiliation: Swansea University
Swansea University
Prince of Wales Private Hospital
University of Warwick
Swansea University
Swansea University
Swansea University
University of Sheffield
University of Warwick
Swansea University
Swansea University
Deputy Principal's Office
Swansea University
Swansea University
Swansea University

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