An International Network to Enhance Older Adult Transitions between Emergency Departments & Communities (iNET)

iNET har bidratt til å etablere et verdensledende nettverk av forskere, beslutningstakere, tjenesteytere og studenter for utvikling og testing av strategier for pasientforløp mellom legevakt/akuttmottak og de kommunale helse- og omsorgstjenestene. I prosjektet har vi kommet langt i å etablere en felles enighet om hva som kjennetegner de optimale pasientforløpene og de mest hensiktsmessige evalueringsmetodene. Vi har også arbeidet systematisk med å utforske hvordan ulike strukturer og politiske føringer i Norge og Canada (Manitoba og Alberta) påvirker pasientforløpene. Vi har identifisert hvilke administrative datasystemer som er tilgjengelig for å kunne sammenligne pasientforløp i Norge og de to kanadiske provinsene, og gjennom et større NFR prosjekt med basis iNET-nettverket, Knowledge to action (K2), er vi i gang med å analysere data fra disse administrative systemene i Norge, og er i gang med planleggingen for å kunne gjøre det samme for kanadiske data fra Manitoba provinsen. Nettverksaktivitetene har bestått av fem tredagers arbeidsseminar, der de to første var gjennomført som online seminar grunnet Covid-19 pandemien. Mellom og parallelt med seminarene har vi gjennomført læringsaktiviteter for studenter, og student- og forskermobilitet. En scoping review knyttet til kvalitetssikring av pasientoverføringer fra sykehjem til sykehus er innsendt tidsskrift for review, samt et systematisk arbeid for å utforske kontekstuelle forskjeller mellom Manitoba, Canada, og Norge som påvirker pasientoverføringer fra sykehjem. Prosjektet ledes av Senter for omsorgsforskning, vest ved Høgskulen på Vestlandet (HVL), og med to kanadiske institusjoner, University of Manitoba og University of Alberta, og en norsk institusjon, NORCE (Senter for legevaktsmedisin) som partnere.

iNET has addressed one of the 17 United Nations sustainability goals (Goal 3, Good health and Well-being), specifically by aiming to improve older adult transitional care. The activities carried out during the project period align with priority documents in Norway (i.e., The Coordination Care Reform), Canada (CIHR’s Transitions in Care Platform), and the recently announced Canada-EU Smart Living Environment Initiative designed to enhance care transitions for aging people. Each of these documents emphasize the need to enrich community-based care options for higher risk individuals, to improve care coordination between communities and EDs/hospitals when the need arises, and more generally to ensure that high caliber research is available to help develop, sustain, and scale-up highly effective transition practices. Our team of researchers, healthcare planners and practitioners have collaborated extensively to enrich the transactional space between research and practice, to ensure proper treatment at the right place and time. Most of the activities in this project has involved practitioners and decision-makers from all three jurisdictions, Norway and the two Canadian provinces of Manitoba and Alberta. The decision-makers have been recruited both from the level of jurisdiction (in the case of Norway, the Directorate of Health) and from the level of local government (municipalities). This all have ensured that decision-makers and practitioners have 1. Influenced the project planning and activities, 2. Contributed to student learning, 3. Shared results from project activities with colleagues in local and national/province government and in practice sites like hospitals, EDs and municipal health care services.

iNET relates to and builds on two ongoing projects funded by the Research Council of Norway and led by the Centre for Care Research (CCR) at the Western Norway University of Applied Sciences (HVL): WELCARE (2019-24) and (PRIMORE (2018-21), see attached project description for details. Each of these projects study manners to improve ED transitions for older adults. iNET builds thematically on these projects and fulfills the objectives of INTPART by (1) engaging with two well-known Canadian institutions (the University of Manitoba, UM; the University of Alberta; UA), both of which are renowned for their international research and faculty with established relevant expertise; (2) ensuring that iNET engages formally across institutions to help optimize and sustain our program success; (3) interacting with healthcare stakeholders in ways that help to ensure that our products have ‘real-world’ impact, and; (4) improving post-graduate student training (e.g., advancing curricula; providing international exchanges; creating international co-advisory committees), to successfully train future health services research leaders. iNET will create a world-class network of researchers, healthcare decision makers & providers, and students with the collective expertise to develop and test strategies to improve older adult care transitions from the community (comm) to emergency departments (ED) / hospitals (H) and back (comm?ED/H) (TABLE 1) . Network activities will consist of five 3-day workshops interspersed with student training plus faculty exchanges. Team members will first collaborate to define best comm?ED/H transition practices & evaluation methods, second will assess the ways in which different healthcare policies & structures impact these practices, and third will identify existing administrative data systems that are available to directly compare how different kinds of comm?ED/H transitions work.