Sustaining health care innovation in care homes: the SUSTAIN-CH study protocol

Introduction: Sustaining effective interventions that improve quality and safety of care is a key challenge in improving the outcomes of healthcare. In recent years in the UK, there have been innovations to improve healthcare in care homes. They were led by dedicated project teams and had time-limited funding. This study aims to determine whether and how any improvements brought about by these innovations were sustained. Methods and analysis: This study will examine three care home healthcare improvement projects: Enhanced Health in Care Homes; Proactive Healthcare of Older People in Care Homes (PEACH); and Safer Salford Care Homes. Each of these projects sought to improve the quality of care in care homes. The study will collate administrative documentation from each project, and carry out approximately 32 semi-structured interviews with project managers, health and social care professionals, support staff, quality improvement experts, and clinical/care home experts. Data will be used to create a description of the three interventions, applying the Template for Intervention Description and Replication (TIDieR) framework. Interview data will be analysed thematically by two independent researchers using the Consolidated Framework for Sustainability (CFS) to examine which factors impact on sustainability in the care home setting, and explore why and how these factors influence sustainability. The findings will be used to develop guidance and practical strategies for future teams working on quality improvement in care homes