An outcomes evaluation of an Australian Hospital in the Nursing Home admission avoidance programme

Abstract

With a demonstrated reduction in in-hospital LOS, the available bed space created can be used for other patients perhaps waiting in the ED or waiting for surgery.

Trends and predicted trends in presentations of older people to Australian emergency departments: effects of demand growth, population aging and climate change

“…37,38 ED substitutive care models have been best described in the residential aged care population and encompass either nurse-led or integrated care models, and have been demonstrated to reduce both ED presentations and in-patient length of stay of residents of aged care facilities. 37,39 Current emphasis on activity-based funding (ABF) models serves as a disincentive for health services to adopt these innovative programs, because they largely do not attract ABF funding for ED substitutive care elements of the programs. Governments will need to address these funding disincentives to facilitate meeting of future projected growth in ED demand.…”

Emergency Department presentation of frail older people and interventions for management: Geriatric Emergency Department Intervention

“…However, this model only caters for older people from RACFs and research evaluation of CAREPACT is not published in the literature at the time of writing. HINH provides an outreach service delivering acute care nursing support services, medication and equipment to the RACF nurse [13] to prevent admission to hospital and fast-track discharge back to the RACF for appropriate elderly people thereby avoiding admission. GEDI does not provide mobile assessment and treatment resources as the current focus is on admission avoidance.…”

“…Evidence of the efficacy of health service interventions aimed at providing appropriate care for ageing populations is present in the literature with varying levels of success reported [9][10][11][12][13][14][15][16][17][18]. Some examples of these interventions are: improving care in RACFs via change in staffing models most often to include a Nurse Practitioner [11], interventions in EDs for presentation of older people, and outreach models from health services to the community most often provided by nurses, hospital in the home (HITH) and hospital in the nursing home (HINH).…”

“…Attention to the design of a specific area in the ED to introduce natural lighting and noise reduction in an effort to be more 'older people friendly' , similar to such areas for pediatrics, is increasing in popularity [17]. There is some evidence that outreach interventions such as HiTH and Hospital in the Nursing Home (HINH) as exemplars for supported early discharge also result in decreased admission rates from RACFs to EDs and reduced length of stay if admitted [13,20,21].…”

A structure, process and outcome evaluation of the Geriatric Emergency Department Intervention model of care: a study protocol

“…In an attempt to keep frail older persons at their place of residence during an acute illness, several MOC have been designed and tested. Broadly, the different MOC are divided into those that: i) provide in-home care or outreach of services from one service to another [12, 24, 27, 28]; ii) provide prioritisation or geriatric focused care in the ED [29–32]; or iii) support or enhance primary care [28, 33]. …”