Home care and emergency medicine: a pilot project to discharge patients safely from the emergency department.

Abstract

To describe in detail the implementation of an acute care home care program (quick response program; QRP) for the emergency department (ED). A prospective observational study with key process and outcome indicators, including number of referrals, time to initiate service, type of home care provided, number of return patients to the ED, and outcome for all patients, defined at the beginning of the project. Patients are identified for the QRP and services are in place within four hours of patient discharge. Of 177 eligible patients, 121 were entered into the program. Sixty-eight percent were more than 65 years old, and 54% lived alone. All patients met the time target of services in place within four hours of discharge from the ED. Patient satisfaction was high as measured by an independent survey instrument. Fifty percent of the patients required no further service after the QRP, but 20% were admitted to hospital within 30 days. A QRP can be successfully implemented in the ED to discharge patients home, most of whom would have been admitted to hospital.