Factors influencing decision‐making processes for unwell residents in residential aged care: Hospital transfer or Residential InReach referral?

Abstract

Availability of timely and appropriate medical and nursing care in RACFs was reported to influence transfers to the hospital and/or referrals to RiR. RiR was used to complement or substitute usual care available to residents. Further research and improvements in RACF and RiR resources are required.

Delivering inclusive and quality services in community and residential aged care settings

“…Several studies have assessed models for improving the aged care home to hospital nexus for better resident health outcomes . Evidence suggests there is a facility preference for managing health transitions in‐house for continuity and understanding of residents’ needs and functionality; however, facilities are often not equipped with the staff and resources needed to manage unwell residents . For example, residential aged care staff and general practitioners reported valuing and relying upon Residential InReach to manage unwell aged care residents and avoid hospital transfers .…”

“…Evidence suggests there is a facility preference for managing health transitions in‐house for continuity and understanding of residents’ needs and functionality; however, facilities are often not equipped with the staff and resources needed to manage unwell residents . For example, residential aged care staff and general practitioners reported valuing and relying upon Residential InReach to manage unwell aged care residents and avoid hospital transfers . Utilisation of this service depended upon the availability of timely and appropriate medical and nursing care in the aged care facility, and Residential InReach was used to complement or substitute the usual care available to residents .…”

“…For example, residential aged care staff and general practitioners reported valuing and relying upon Residential InReach to manage unwell aged care residents and avoid hospital transfers . Utilisation of this service depended upon the availability of timely and appropriate medical and nursing care in the aged care facility, and Residential InReach was used to complement or substitute the usual care available to residents . In comparison, when care coordination was organised through the Emergency Department there were more challenges in communication, referrals and transfers between locations than benefits to the resident .…”

“…In comparison, when care coordination was organised through the Emergency Department there were more challenges in communication, referrals and transfers between locations than benefits to the resident . Facilitators of in‐house care included strong clinical expertise and support, and computerised medical records with connectivity to general practitioners . However, there was also conflict between the wish to care for residents in‐house and concern about duty of care obligations and litigation .…”

Perspectives of general practitioners and nursing staff on acute hospital transfers of nursing home residents in Germany: results of two cross-sectional studies

“…Several approaches discussed for reducing inappropriate hospital transfers include better interprofessional collaboration [25,33,37,41,48]. However, most of the existing literature on reasons for hospital transfers of NH residents and areas for improvement only focussed on just one of these healthcare professionals [35,37,40,43,48], or had small sample sizes [39,49,50]. Moreover, research on this topic from Germany is rare.…”