Abstract
BackgroundAn existing hospital avoidance program, the Aged Care Rapid Response Team (ARRT), rapidly delivers geriatric outreach services to acutely unwell or older people with declining health at risk of hospitalisation. The aim of the current study was to explore health professionals’ perspectives on the factors impacting ARRT utilisation in the care of acutely unwell residential aged care facility residents.MethodsSemi-structured interviews were conducted with two Geriatricians, two ARRT Clinical Nurse Consultants, an ED-based Clinical Nurse Specialist, and an Extended Care Paramedic. Interview questions elicited views on key factors regarding care decisions and care transitions for acutely unwell residential aged care facility residents. Thematic analysis was undertaken to identify themes and sub-themes from interviews.ResultsAnalysis of interviews identified five overarching themes affecting ARRT utilisation in the care of acutely unwell residents: (1) resident care needs; (2) family factors; (3) enabling factors; (4) barriers; and (5) adaptability and responsiveness to the COVID-19 pandemic.ConclusionVarious factors impact on hospital avoidance program utilisation in the care of acutely unwell older aged care facility residents. This information provides additional context to existing quantitative evaluations of hospital avoidance programs, as well as informing the design of future hospital avoidance programs.
Highlights
Population ageing is occurring in many countries, including Australia [1]
Five (83.3%) participants were staff from the two hospitals operating within the Aged Care Rapid Response Team (ARRT) service area, and one (16.7%) was employed by NSW Ambulance
Of the five hospital staff, three (60.0%) were ARRT staff, one (20.0%) was an Emergency Department (ED)-based Clinical Nurse Specialist working with older people who present to the ED, and one (20.0%) was a Clinical Director and Geriatrician
Summary
Population ageing is occurring in many countries, including Australia [1]. Ageing is associated with multiple chronic health conditions and greater use of health and aged care services [2, 3]. Rising hospital service utilisation has been observed, with older people overrepresented in the hospitalised population [4]. Care for acutely unwell RACF residents for some health conditions can potentially be delivered outside of an acute hospital setting [6]. Hospital avoidance programs have been designed and implemented in multiple aged care settings to reduce unnecessary ED transfers and the associated. An existing hospital avoidance program, the Aged Care Rapid Response Team (ARRT), rapidly delivers geriatric outreach services to acutely unwell or older people with declining health at risk of hospitalisation. The aim of the current study was to explore health professionals’ perspectives on the factors impacting ARRT utilisation in the care of acutely unwell residential aged care facility residents
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