IMPLEMENTATION OF A NURSE-LED COMMUNITY CARE PROGRAM FOR SENIOR CITIZENS IN BASELLAND (CH): THE INSPIRE PROJECT
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Abstract In January 2018 a new legal framework to redesign community care for older people was approved in Canton Baselland (Switzerland): 86 municipalities will merge into 8 to 9 care regions. Each care region needs to implement a care model for older people including a nurse-led assessment and care advice center. INSPIRE aims to develop, implement and evaluate the impact of care model on patient-, provider- and system level. INSPIRE is a hybrid type 1 effectiveness-implementation design that combines the evaluation of clinical effectiveness of the care program, while gathering information about implementation strategies. Using implementation research methods, a context-sensitive care model is being developed and implemented by involving stakeholders in each project phase. The developed model of care is based on risk stratification of the older population and supply of health and social services according to the individual’s needs. The 3-year INSPIRE project consists of 6 work packages: 1) Cantonal and local stakeholder involvement, 2) literature review to identify core components of evaluated community care models, 3) contextual analysis of Canton Baselland, 4) development of intervention and implementation protocols including a training package for advanced practice nurses in geriatrics, 5) development of a monitoring system based on clinical, insurance and population-cohort data, and 6) process and outcome evaluation in a pilot-region. INSPIRE will enable the implementation of a new care model by involving stakeholders in co-creating a care concept that is based on scientific evidence, is feasible and acceptable, and fits the local context.