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‘RE-AIM’ has been repeatedly recognised for its optimal capacity of providing an evaluative research framework for in the context of practice based disciplines, which necessitate pragmatic outcomes that can drive reflection on current practice and enable critically reflexive responses. Most importantly it is straightforward to implement in the context of healthcare practice. As an acronym RE-AIM acts to abbreviate five key terms, Reach, Effectiveness, Adoption, Implementation, and Maintenance.
This methodological framework provides a pragmatic starting point for establishing the degree of impact certain interventions in healthcare may have had by assessing each multi-disciplinary professional group’s engagement with the intervention, in this study, the patient care transfer pathway.
As a framework RE-AIM is undertaken over five key areas, namely
Reach (R), which provides an insight into the uptake of a particular scheme of intervention, their evaluation of the process and any issues for address, in this case, ‘Red Bags’
Effectiveness (E), which in this study operationally defined the most salient positive and negative perceptions of the Red Bag implementation across the North East and North Cumbria, UK
Adoption (A), which was functionally aligned to the percentage of possible uptake of the scheme relative to the organisation numbers invited to do so
Implementation (I), which gave an insight into the extent to which the Red Bag scheme had been implemented as it was originally intended and finally
Maintenance (M), which provided an insight into how sustainable the implementation the intervention might actually be, beyond an initial implementation phase of twelve months.
To date, implementation of RE-AIM has been widely reported in evaluative practice, although few of these have been specifically focused on multi-agency level, collaborative organisational partnerships.
Ours is therefore one of the first multi-faceted initiative to incorporate an implementation geared at multi-disciplinary partnership working in the North East and Cumbria, regions of the UK. As an integral part of translational research evaluation, then, RE-AIM, is a valuable methodological approach for appropriating the most relevant approaches to real world interventions.
The ‘Red Bag’ is predominantly a quality improvement scheme designed to ensure that patient records are transferred to and from secondary care settings in such a manner that medical documentation can be transferred from one healthcare context to another in an optimal manner. Whilst this study focused specifically on the implementation phase, it is also possible for the methodology to focus on specific aspects identified by the RE-AIM acronym, such as reach or sustainability (maintenance).
The overall purpose of the present report is to investigate the usefulness of RE-AIM as a methodological approach for the capture of the implementation phase of the Red Bag scheme in practice, between residential care home settings, paramedic practice and secondary care settings in regional hospitals across the North East and Cumbria, England, UK.
In 2015, the National Institute for Health and Care Excellence introduced guidance on the transfer of patients with social care needs from care homes and community settings to hospital (National Institute for Health and Care Excellence, 2015). Transfer Pathway, is designed to support care homes, ambulance services and the local hospitals to meet the recommendations of the NICE guideline NG27 ‘Transition between inpatient hospital settings and community or care homes’.
The Hospital Transfer Pathway which incorporated the Red Bag, was introduced by Sutton Clinical Commissioning Group in 2016 to improve the handover process between care homes and ambulance staff when a resident is admitted to hospital in Sutton. The aim of the Hospital Transfer Pathway was to improve communication and minimise delays in transfers whilst paperwork was collated, loss or lack of personal belongings not going with the resident to hospital and medical teams not having baseline information on the residents’ health, medications, or specific needs, which can result in unnecessary delays and lack of communication (Sutton Clinical Commissioning Group, 2016).