The proportion of people aged over 85 years will double by 2035, markedly increasing NZ's care burden and health care expenditure. We must develop new ways to support the medical/disability 'industry', including residential aged care (RAC), that improve outcomes, e.g. by reducing acute hospitalisations which are potentially hazardous for frail older people. This project aims to improve RAC outcomes, including reducing costly hospitalisations, by establishing cost-effectiveness of a current potentially successful research project, and by developing/enacting an implementation plan to support and up-skill RAC caregivers. We aim to: compare costs of delivering the clinical package of our Aged Residential Care Health care Utilisation Study [ARCHUS] (assuming its success) against costs saved in reduced emergency hospital admissions; identify areas for improvement in ARCHUS delivery and develop a best-practice model; ensure improvements continue following implementation and are widely disseminated via the Northern Regional Health Plan - Health of Older People Network Group.