Prevention of acute admIssion algorithm

Acute admission can be appropriate and lifesaving, but may also in itself lead to adverse health outcome, such as patient anxiety, functional loss and hospital-acquired infections. Timely identification of older citizens at increased risk of acute admission is therefore needed.

The ‘PATINA algorithm and decision support tool’ is designed to alert community nurses of older citizens showing subtle signs of declining health and at increased risk of acute admission.

In a stepped-wedge cluster randomized controlled trial, we implement and test PATINA algorithm and decision support tool in 20 individual area home care teams across three Danish municipalities (Kerteminde, Odense and Svendborg). The study population includes all home care receiving community-dwelling citizens aged 65 years and above.

The primary outcome is acute admission. Secondary outcomes are readmissions, preventable admissions, death, and costs of health care utilization. Barriers and facilitators for community nurse’s acceptance and use of the algorithm will be explored too.