NCT07166653

Hospital-at-Home Education as Implementation Tool - RCT

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

• Status: Recruiting
• Phase: N/A
• Study type: Interventional
• Enrollment: 14 (estimated)
• Sponsor: Nordsjaellands Hospital · Academic / Other
• Sex: All
• Age: —
• Healthy volunteers: Accepted

Summary

To enhance implementation of Hospital-at-home (HaH) in Scandinavia, the Nordic Digital Health \& Education (NorDigHE) project has developed a comprehensive virtual education on HaH for clinical staff. The goal of this clinical trial is to evaluate whether an online education for clinical staff can enhance the implementation of HaH services in hospitals across Denmark, Norway, and Sweden. The primary outcome of the RCT is HaH implementation measured at organization level, understood as a change in clinical practice by increased HaH activity. Secondary outcomes are HaH knowledge and motivation among clinical staff as well as patient days in hospital, days hospitalized at home, 30-day readmission, and mortality. Researchers will compare hospitals receiving the NorDigHE education (intervention group) to hospitals continuing treatment as usual (control group) to see if the education leads to greater adoption of HaH and changes in service delivery. Participants will: * Complete baseline, 3-month, and 6-month surveys assessing HaH activity, staff knowledge, and motivation. * Participate in a 12-month follow-up assessment (intervention group only). * Be invited (patients, staff, and management) to take part in semi-structured interviews to share experiences and preferences related to HaH. * (For staff in the intervention group) Complete the NorDigHE virtual education program embedded in the WHO Fast-IM. After the study, the control group will be offered access to the NorDigHE education as a participant retention measure.

Detailed description

Background: In response to increasing pressures on healthcare systems due to aging populations, and increasing shortages of clinical staff, increased use of digital service designs has been recommended by most governments in Scandinavian and European countries. Virtually supported Hospital-at-Home (HaH) models, delivering acute hospital services in-home have been shown to be both feasible and beneficial. Nevertheless, implementation and scaling barriers are major challenges. To enhance implementation of HaH in Scandinavia, the Nordic Digital Health \& Education (NorDigHE) project has developed a compre-hensive virtual education on HaH for clinical staff. The present study aims to evaluate the implementation impact of the NorDigHE education embedded in the WHO Fast-track Implementation Model (WHO Fast-IM). Methods and analysis: We use a randomized design and nested qualitative studies to meet the aim. Via open-call, hospitals will be recruited in Denmark, Norway, and Sweden and randomized to either receive the education embedded in the WHO Fast-IM or to continue treatment as usual. The primary outcome of the RCT is HaH implementation measured at organization level, understood as a change in clinical practice by increased HaH activity. Secondary outcomes are HaH knowledge and motivation among clinical staff as well as patient days in hospital, days hospitalized at home, 30-day readmission, and mortality. Data are collected at baseline, after 3, and 6 months. A 12-month maintenance measurement is performed in the intervention group. Post-study, the control group is offered the NorDigHE education as a participant re-tention measure. In addition, the attitudes, experiences, and preferences of HaH among patients, clinical staff, and management are collected via nested semi-structured interviews.

Conditions

• Hospital

Interventions

Type	Name	Description
BEHAVIORAL	HaH education	The intervention consists of the online NorDigHE HaH education with tailored implementation tools em-bedded in the WHO Fast-IM. The education is delivered online and asynchronously, combining e-learning, simulations, reflection exercises, and practical task training. The trial has adopted the evidence-based WHO Fast-track Implementation Model (WHO Fast-IM) as a framework to support the effectiveness and reporting of the implementation, and the tailored implementation tools embedded in the model will be provided as part of the intervention to support in-tegration into daily clinical routines. The tailored toolbox consists of workshops, introductory meetings, written guides, and access to a hotline staffed by project specialists to facilitate implementation.

Timeline

• Start date: 2025-09-01
• Primary completion: 2026-12-01
• Completion: 2026-12-31
• First posted: 2025-09-10
• Last updated: 2025-09-10

Locations

3 sites across 3 countries: Denmark, Norway, Sweden