INTERSCALE Study

INTERSCALE is a research project funded by the Nursing Science Foundation and the Swiss National Science Foundation (SNSF), which aims to conduct a scale-up of the nurse-led care model INTERCARE. It will examine whether a set of less resource-intensive implementation strategies compared to those developed for the INTERCARE model are able to support the implementation of INTERCARE to achieve an equally successful reduction in unplanned transfers and a sustained implementation of INTERCARE. The cost-effectiveness of implementation strategies will also be assessed.

For this purpose, the INTERCARE model will be adapted and updated on the basis of the experiences from INTERCARE and simultaneously a lighter set of implementation strategies will be developed.

The introduction of a nurse-led care model is an organizational development process that needs to be carefully guided and supported. Various implementation strategies were used to successfully introduce INTERCARE in Residential Long-Term Care (LTC) facilities. These included introductory meetings and bi-monthly coaching sessions for LTC facility leadership, an educational program and bi-weekly coaching sessions for the INTERCARE nursing staff, feedback and benchmarking on quality indicators, and proving material to implement INTERCARE. The LTC facilities found the implementation strategies very helpful and important for successful implementation. However, from an implementation perspective, the strategies used were very costly and resource-intensive for both, the LTC facilities and the research group. To broadly spread INTERCARE in the future, it is crucial that implementation strategies have a suitable cost-benefit ratio.

The INTERSCALE research project consists of project work package (WP) 1 (2022-2023) and WP2 (2023-2026). The project will take a total of 5 years (2022-2026).

The aim of WP1 is to build the scalable unit of INTERCARE, which refers to updating the INTERCARE model and adapting the initial set of implementation strategies used to support the implementation of INTERCARE in the LTC facilities, as well as developing a new set of lighter implementation strategies. In WP2, the aim is to implement INTERCARE and to evaluate the effect of the lighter set of implementation strategies on implementation outcomes, costs, and resident outcomes in approximately 40 LTC facilities in German-speaking Switzerland.

INTERSCALE allows to generate evidence-based statements on how LTC facilities can be supported in a cost-effective way to successfully implement a nurse-led care model like INTERCARE. A participatory approach allows for the development of implementation strategies that are appropriate and acceptable for the LTC setting in the German-speaking part of Switzerland.

This study will produce a publicly available report describing and evaluating the different implementation strategy sets. These findings will allow policy makers, provider associations and other organizations to optimally support LTC facilities in strengthening nursing expertise and further developing nursing quality in order to face current and future challenges.

INTERSCALE is financially supported by: