It is well documented that transporting frail, elderly residents to busy and noisy emergency departments exposes them to distress, delirium and potential falls. St Vincent’s has developed a residential outreach program to rescue emergency department presentation from residential aged care residents.
The program provides clinical nursing and medical support to aged care residents within their home environment. Since its inception, its exceptional patient-centred care has seen it grow to provide a seven day a week service to residents, staff and general practitioners.
The program receives almost 100 referrals a month from aged-care residential facilities, for things such as confusion, dehydration, malfunctioning devices (e.g. catheters, PEGs), chest infections, functional decline, and end of life care. 86 per cent of patients seen by the outreach team are able to remain at their facility and avoid presentation to ED.
The team’s leader Darren Gaut says feedback has shown GPs, staff, patients and families all find the service very valuable.
“It offers cost-effective, right care at the right time in the right place, for patients and their families, whilst alleviating unnecessary hospital demand,” Darren says.
When asked what they would have done if the outreach team were not able to attend, some aged care staff said they would attempt to contact a local doctor (who were often not available) but most said they would call an ambulance for transfer to hospital.
Director of St Vincent’s Emergency Department, Dr Andrew Walby, agrees. “I don’t know how we functioned in the days before this program. Their support for patients, families and health professionals is invaluable. Best of all, the patients get the best care in the best environment.”
The program is now part of a state-wide Victorian Department of Health and Human Services (DHHS) initiative. Recent collaboration with Medicare Locals and the DHHS has seen this outreach model expanded to include clinical after-hours and weekend services, and a capacity building education program to enable aged care facilities to support their residents in their own home environment.