Online training to support Hospital-at-Home services in Scandinavia

Nordic Digital Health Education as an Implementation Tool for Hospital-at-home - Protocol for a Multicenter Randomized Controlled Trial

This project will test whether an online education program for clinical staff helps hospitals in Denmark, Norway, and Sweden start or expand Hospital-at-Home services.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 14 (estimated)
• Sex: All
• Sponsor: Nordsjaellands Hospital (Academic / other)
• Locations: 3 sites (Hillerød, Capitol Region of Denmark and 2 other locations)
• Trial ID: NCT07166653 on ClinicalTrials.gov

What this trial studies

Using a randomized design, hospitals in Denmark, Norway, and Sweden will be assigned to receive the NorDigHE online education embedded in the WHO Fast-track Implementation Model or to continue usual practice. The primary outcome is implementation at the organizational level, measured as increased Hospital-at-Home activity, with secondary outcomes including staff knowledge and motivation, patient days in hospital, days hospitalized at home, 30-day readmission, and mortality. Data will be collected at baseline, 3 months, and 6 months, with nested qualitative studies to explore barriers and facilitators. Hospitals are recruited via open call and must have or be ready to establish essential governance, IT, communication, and clinical guideline prerequisites for HaH.

Who should consider this trial

Good fit: Ideal participants are hospitals in Denmark, Norway, or Sweden with clinical departments treating acutely ill inpatients that have, or are ready to establish, governance, an IT platform, safe patient–hospital communication, data agreements, defined roles and capacity, and clinical guidelines for Hospital-at-Home.

Not a fit: Patients who require intensive in-hospital interventions or who live outside the service area of participating hospitals are unlikely to receive direct benefit from this program.

Why it matters

Potential benefit: If successful, more patients could receive acute care at home, reducing time in hospital and associated risks while increasing comfort and convenience.

How similar studies have performed: Virtually supported Hospital-at-Home models have demonstrated feasibility and patient benefits in prior work, but applying a multi-country online education program to drive widespread implementation is relatively novel.

Eligibility criteria

Inclusion criteria:

Hospitals with clinical departments treating acutely ill in-patients that have, or are ready to establish, the prerequisites and infrastructure for HaH - regardless of the specific approach, envisioned HaH model, primary sector collaborations, or local sector collaboration agreements and frameworks. Each hospital must have or be ready to establish:

1. a governance structure to organize and oversee HaH-services.
2. an IT-platform capable of managing data from and to HaH patients.
3. a safe communication pathway between HaH-patient and the hospital.
4. clear agreements on types of data to be exchanged between HaH-patient and hospital.
5. agreements on roles, responsibilities, and capacity (incl. possibly primary sector entities).
6. clinical guidelines, standard operating procedures, and action plans to support the HaH work.

Exclusion Criteria:

* Hospitals that do not have or are not ready to secure relevant pre-requisites listed above (a to f).

Where this trial is running

Hillerød, Capitol Region of Denmark and 2 other locations

• Nordsjællands Hospital — Hillerød, Capitol Region of Denmark, Denmark (Recruiting)
• University College of Østfold — Fredrikstad, Østfold fylke, Norway (Recruiting)
• Sahlgrenska University hospital — Göteborg, Skåne County, Sweden (Recruiting)

Study contacts

• Principal investigator: Thea K Fischer — Forskningsafdelingen, Nordsjællands Hospital
• Study coordinator: Mie H Martinussen

Conditions Hospital; clinical competence; digital health; education; hospital at home; hospital in the home; implementation; telemedicine