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ACTIONS FOR POLICY AND IMPLEMENTATION
Residents of aged care facilities face escalating health issues which result in elevated hospital admissions. Reducing avoidable hospital transfer is desirable and should be encouraged as a way to reduce stress and risk of adverse complications, and further to reduce health service costs overall.
Supporting residential aged care workers to detect deterioration early, and proactively manage residents within the home, could reduce unnecessary hospital transfers and improve patient experience and outcomes.
The viability of this model must be trialled for efficacy. The EDDIE+ project is designed to enhance the skillset of staff in identifying and manageing deterioration. It will examine the impact on resident transfers to hospital, hospital length of stay and health service costs.
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RESEARCH CONTEXT
Today, more than 240,000 Australians call a residential aged care (RAC) facility home. Many of these residents are frail with escalating comorbidities where the priority for medical care is management rather than cure. However, this group are frequent users of hospital services, with admissions being stressful, costly and often unnecessary or preventable. If deterioration is identified early, intervention in the aged care home can occur resulting in less emergency department presentations and decreases associated risks in the elderly if hospitalised.
The EDDIE + research project is a multicentre randomised control trial funded by a National Health and Medical Research Council (NHMRC) Medical Research Future Fund (MRFF) Keeping Australians Out of Hospital Project Grant (GNT1177501), This facility-driven program, rolled out in 11 Queensland RAC homes operated by Bolton Clarke from March 2021 – May 2022, promotes practice change and improvement so that deteriorating residents can be identified early and managed proactively, reducing the need for transfer to hospital, or, shortening length of stay.
The program is designed to enhance the skills and confidence of nursing and care staff. Combining education, additional resources, such as equipment, decision support tools, and implementation facilitation and clinical system support, the program components aim to support sustainable practice change.
The project recently hosted a webinar titled “Avoiding hospital transfer from residential aged care: current Queensland Initiatives”. Speakers from 7 hospital avoidance programs across Queensland each highlighted how their work is improving care for people in residential aged care. The webinar concluded with a thought-provoking panel discussion, providing a strong platform for further discussion and collaboration. To access the recording and view the webinar storyboard you can visit the project website here. The project trial phase of this project has recently concluded with results expected early 2023.
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