251Patients in a Step Down Geriatric Rehabilitation Hospital – What are the Reasons for Transfer Back to an Acute Hospital?

Abstract

Background: To alleviate the bed crisis in our acute hospitals, suitable patients are being transferred to Step Down facilities for further rehabilitation. These patients are then managed by a Consultant led MDT until discharge home. Clontarf Orthopaedic Hospital hosts 80 beds dedicated to rehabilitation of patients post acute injury or illness. The patients are transferred from 2 acute Dublin Hospitals - The Mater Misericordiae, (48 beds) and Beaumont Hospital (32 beds). The gender breakdown is 2: 1 Female to Male. During their stay some patients require readmission to an acute hospital. The purpose of this study is to assess the cause. Methods: This study was a retrospective review of all patients transferred out from the Clontarf Active Rehabilitation Unit over a 4 month period. The reason for patient transfer and whether they were admitted to the acute hospital or reviewed in Accident and Emergency and returned to the rehab facility was studied. Results: In a 4 month period there were 38 transfers in total, 8 male and 30 female patients. Of those, 32 were admitted and 6 were investigated and treated in Accident and Emergency and discharged back to rehab within 24 hours. The most common reason for transfer was for sepsis (18 Patients). There were 4 FAST calls; 4 patients were transferred for cardiac causes; 3 for anaemia. Falls, fracture and head injury accounted for a further 4 cases. A further 4 patients were transferred for other causes (DKA, Asthma, GI Obstruction and PR Bleed). Conclusion: The majority of patients requiring acute hospital transfer required transmission. The vast majority of transfers were for sepsis, with FAST calls for potential CVA and cardiac causes also featuring as significant cause.