In-reach nursing services improve older patient outcomes and access to emergency care

  • Street M
  • Considine J
  • Livingston P
 et al. 
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AIMS: To identify the impact of in-reach services providing specialist nursing care on outcomes for older people presenting to the emergency department from residential aged care. METHODS: Retrospective cohort study compared clinical outcomes of 2278 presentations from 2009 with 2051 presentations from 2011 before and after the implementation of in-reach services. RESULTS: Median emergency department length of stay decreased by 24 minutes (7.0 vs 6.6 hours, P < 0.001) and admission rates decreased by 23% (68 vs 45%, P < 0.001). The proportion of people with repeat emergency department visits within six months decreased by 12% (27 vs 15%). The proportion of admitted patients who were discharged with an end of life palliative care plan increased by 13% (8 vs 21%, P = 0.007). CONCLUSIONS: There was a significant reduction in the median length of stay, fewer hospital admissions and fewer repeat visits for people from residential aged care following implementation of in-reach services.

Author-supplied keywords

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Emergency Service, Hospital/*organization & admini
  • Female
  • Geriatric Nursing/*organization & administration
  • Health Services Accessibility/*organization & admi
  • Homes for the Aged/organization & administration
  • Hospital Mortality
  • Humans
  • Length of Stay
  • Male
  • Nursing Homes/organization & administration
  • Nursing Service, Hospital/*organization & administ
  • Palliative Care
  • Patient Admission
  • Patient Discharge
  • Patient Transfer/organization & administration
  • Retrospective Studies
  • Terminal Care
  • Time Factors
  • Victoria
  • emergency medicine
  • health services access
  • health-care reform
  • nursing home
  • older person

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  • M Street

  • J Considine

  • P Livingston

  • G Ottmann

  • B Kent

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