Uptake and use of a minimum data set (MDS) for older people living and dying in care homes in England: a realist review protocol

Introduction: Care homes provide nursing and social care for older people who can no longer live independently at home. In the UK, there is no consistent approach to how information about residents’ medical history, care needs, and preferences are collected and shared. This limits opportunities to understand the care home population, have a systematic approach to assessment and documentation of care, identify care home residents at risk of deterioration, and review care. Countries with standardised approaches to residents’ assessment, care planning and review (e.g. Minimum Data Sets (MDS)) use the data to understand the care home population, guide resource allocation, monitor services delivery and for research. The aim of this realist review is to develop a theory-driven understanding of how care homes staff implement and use MDS to plan and deliver care of individual residents. Methods and analysis: A realist review will be conducted in three research stages. Stage one will scope the literature and develop candidate programme theories of what ensures effective uptake and sustained implementation of an MDS. Stage two will test and refine these theories through further iterative searches of the evidence from the literature to establish how effective uptake of an MDS can be achieved. Stage three will consult with relevant stakeholders to test or refine the programme theory (theories) of how an MDS works at the resident level of care for different stakeholders and in what circumstances. Data synthesis will use realist logic of analysis to align data from each eligible article with possible context-mechanism-outcome (CMO) configurations, or specific elements that answer the research questions. Ethics and dissemination: The University of Hertfordshire Ethics Committee has approved this study (HSK/SF/UH/04169). Findings will be disseminated through briefings with stakeholders, conference presentations, a national consultation on the use of an MDS in UK long-term care settings, publications in peer-reviewed journals, and in print and social media publications accessible to residents, relatives, and care home staff. Review registration number: This review protocol is registered on the International Prospective Register of Systematic Reviews (PROSPERO) - CRD42020171323.