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FOR THEIR SAKE: Quality and safety of resident transfers from acute hospitals to residential aged care

McDonald, T. A., 2007

ACAA Conference, Sydney

ABSTRACT

Background: The interface between acute care and residential care of elderly people provides the ingredients for potential disagreement and circumstances which might impact negatively on the care of the residents and their families. In particular, the transfer of residents between acute care and aged care facilities has been the source of significant concerns within the aged care sector.

The Aged Care industry is funded as a supportive service to older Australians trying to lead a fulfilling life despite the inevitable decline of physical function arising from the cumulative effects of illness, disease and trauma. Residential aged care services have a duty to ensure that residents have access to remedial hospitals and other health services as they require it. Close liaison and consultation between hospital and aged care services is needed for the processes around hospital transfers to and from residential care to be achieved safely, effectively, dutifully and efficiently. And outcomes for residents need to be given due regard by all involved. Unfortunately, responses by aged care professionals provide a worrying perception of hospital performance. These respondents have had reason to consult and collaborate with hospital staff in an effort to provide safe and effective care of residents moving between the two service industries.

Objective: The aim of the national survey of the aged care industry in April 2007, was to investigate the extent to which system problems are experienced in relation to resident transfers from hospitals to RACFs; and also the management strategies set up to ensure resident transfers are safe, effective and supportive to them, their families and the aged care home

Methods: The results point to issues of safety and quality arising from hospital efforts in transferring residents back to aged care. Responses by 371 senior aged care respondents provide a worrying perception of hospital performance. These professionals have had reason to consult and collaborate with hospital staff in an effort to provide safe and effective care of residents moving between the two service industries.

Results: The key issues identified in the survey:

  • Lack of care in timing of transfer of residents to aged care facilities
  • Neglect of pre transfer preparations that might delay the freeing up of hospital beds
  • Poor documentation of medical, nursing and other services received by patients
  • Inappropriate management of patients with mental confusion
  • Nutritional deficiencies arising from hospital stay
  • Compromised skin integrity caused by hospital stay
  • Misunderstanding of legal requirements in transfer documentation
  • Disempowering relationships between families and hospital staff
  • Medication safety issues

Conclusions: The impression gained by residents, families and aged care staff of hospital personnel involved with transfers is that many are discourteous and unconcerned with the comfort or safety of older people whom they transfer away from their place of work. Comments in relation to a lack of professional respect emanating from hospitals imply a diminishing level of trust that professionals in the community and in aged care dare to hold about hospital personnel. Such views about the proficiency and diligence of hospital staff make it more difficult to meet due care responsibilities towards older people in this situation, and also to establish a mechanism that supports continuity of care that meets safety and quality standards.

CITATION McDonald, T. (2007) FOR THEIR SAKE: 2007 ACAA quality and safety survey of resident transfers from acute hospitals to residential aged care, Aged Care Association Australia (ACAA) 26th Annual Congress, Sydney Convention and Exhibition Centre, Sydney Australia.

NOTE McDonald, T. A. (2007) For their sake: Can we improve the quality and safety of resident transfers from acute hospitals to residential aged care? (247 pages) Report commissioned by the Aged Care Association Australia. September.


Last updated 18/11/2019
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