Implications for practice include a need for a multidisciplinary approach to developing referral guidelines, staff training and a comprehensive dissemination of information between sectors ultimately to improve quality and continuity of care for the older person.

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Aims. To examine key aspects of the management of the older person in preparation for discharge home from the emergency department to the primary care sector by examining the present levels and organisation of referrals. Background. Older people usually present at emergency departments in response to a medical crisis in their lives. A seamless transition across organisational boundaries is necessary for providing quality health care and to avoid fragmentation of care provision following discharge. Evidence suggests that a lack of communication, documentation and continuity of care between healthcare sectors generally exists. Design. The sample comprised the total population (n ¼ 222) of all medical and nursing staff in the emergency department of one regional hospital and primary care area associated with it. A purposeful sample was used as some members of the primary care team were excluded from the sample. Methods. The method adopted was a survey approach which employed the use of standardised questionnaires comprising both open and closed questioning styles. Raw statistical data were analysed using SPSS SPSS for Windows while the qualitative data arising from the open-ended questions were content analysed for themes. Results. The findings of this study support previous research in that older people continue to be discharged from the emergency department with inadequately determined aftercare needs and deficits in communications with the primary care sector. Conclusion. Current communication between emergency departments and the primary care sector would appear to be disjointed, indicating a need to develop effective referral criteria, accurate documentation and prompt referral. Relevance to clinical practice. Arrangements for discharge from the emergency department that incorporate effective liaison and communications between sectors will contribute to the quality of services for the older person. This will enhance the provision of more efficient aftercare and in the prevention of reoccurrence of health problems and further referral to the emergency department.

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Aims of study.  This study aimed to examine the management of the older person in preparation for discharge home from an emergency department by exploring the perceptions of health professionals on procedures undertaken particularly in relation to the planned support, supply of medications, dressings, and contact information given to patients. An additional aim related to the perceived satisfaction levels of older patients and their carers. Background.  It is imperative that older patients are adequately prepared for discharge home from the emergency department so as to avoid unnecessary anxiety, increase in health problems and possible re-attendance or admission to hospital. Design.  The sample in this study comprised the total population (n = 222) of all medical and nursing staff in both the emergency department and the primary care area. Methods.  The method adopted was a survey approach which employed the use of standardized questionnaires comprising both open and closed questioning styles. Results.  The data obtained identified results similar to previous research in that a discrepancy exists between hospital and community staff in relation to the procedures undertaken when discharging older people from the emergency department, such as arranging follow-up care and appointments and giving the patient relevant contact numbers and dressings. Conclusion.  The findings of this study support previous research in that there is a need to provide patients with planned support, aids and appliances, clear instructions and relevant contact numbers on discharge from the emergency department. Relevance to clinical practice.  Good quality discharge planning is essential for a continuum of care for older people discharged from the emergency department. While patient education is often difficult in the busy emergency department, the provision of relevant information to older patients prior to discharge is essential particularly in relation to prescribed medications and wound care.