Griffiths 2000.

Methods	Study design: RCT using 'Zellen's design' with double consent Unit of allocation: Patient Unit of analysis: Patient Power calculation: Done ‐ powered to detect medium effect sizes Concealment*: Not done. Randomisation from open list held remote from patients prior to patient consent Follow‐up*: 77% of randomised patients consented. 100% of consented patients followed up. Blinded assessment*: Done for length of stay and discharge destination. Not done for functional status. Baseline*: No substantial differences at baseline. Reliable outcomes*: Done for length of stay and discharge destination. Done for functional status ‐ average kappa for each item of Barthel Index greater than .8. Contamination*. Unlikely ‐ control patients not exposed to NLU Intention to treat analysis*: Analysis done on intention to treat basis
Participants	Post‐acute patients referred from acute wards (predominantly med / surgical) of tertiary teaching hospital, assessed as being medically stable and having a remediable nursing need. 63% female mean age 77 mean acute stay 25.2 days. Orthopaedic, gastrointestinal and neurological problems most frequent reasons for initial admission. Treatment 97 Control 80 (77% of assigned patients consented. Full follow up of consenting patients)
Interventions	Unit / setting: 24 bedded unit in satellite hospital providing care of the elderly and rehabilitation services linked to tertiary hospital on separate site (UK). Care management: Nurses assessed suitability for admission and primary nurses on unit planned care. Unit manager (nurse) chaired interdisciplinary meeting Nursing Team: 3 primary nurses + other Registered nurses and nursing aides. 0.75 nurses per patient per day 61% qualified MD team: Physiotherapy, Occupational therapy and social work and medical officer (general practitioner or equivalent) + others including medicine on referral. Team meetings led by unit manager / primary nurse. Education / preparation for staff: Team building and a series of away days prior to implementation. Training in physical assessment for senior staff (primary nurses + those assessing pt suitability). The service developed at the end of a long process of practice development and was developed through a bottom up mechanism. No specific ongoing development orientation for new staff although some in service training on physical assessment. Other: Interventions designed to promote more patient centred and informal environment such as staff wearing own clothes, patient representative on unit management / steering group. Occupational Therapy led activity group. Control: Acute general wards (including elderly care) with 0.86 nurses per patient 75% qualified and routine medically managed care.
Outcomes	Length of stay Health status psychological well‐being physical / functional dependence place of discharge mortality readmission complications Patient Satisfaction In hospital costs Post discharge costs
Notes	Quality score 5/7
Risk of bias
Bias	Authors' judgement	Support for judgement
Allocation concealment?	Unclear risk	D ‐ Not used