Original studyChallenges in Transitional Care Between Nursing Homes and Emergency Departments
Section snippets
Study Design
This investigation collected data via structured focus group interviews, a qualitative group discussion format. The investigation was approved by the IUPUI/Clarian Institutional Review Board via expedited review, and signed informed consent was obtained from all subjects.
Study Setting and Population
We defined “emergency care of nursing home residents” as care they receive immediately before and during an ED visit and after the ED visit if returned directly to the NH without hospital admission. This care takes place in
Results
The subjects in this investigation included the groups listed in Table 2. We studied 5 different health care provider categories, including a total of 42 subjects, in 7 focus group interviews.
Discussion
The transitional care of NH residents has been increasingly discussed in the medical literature over the past several years.3, 4, 5, 6, 7, 8, 11, 12, 18, 19, 20, 21, 22, 23, 24 Despite the knowledge gained from these studies, providers are still working within a system that remains poorly equipped to provide high-quality emergency care to NH residents. The limited success of seemingly promising interventions, such as the introduction of standardized transfer forms,11, 12 discourages the
References (28)
Care of the elderly in emergency departments: Conclusions and recommendations
Ann Emerg Med
(1992)- et al.
Geriatric emergency medicine: A survey of practicing emergency physicians
Ann Emerg Med
(1992) - et al.
Appropriateness of patient transfer from a nursing home to an acute-care hospital: A study of emergency room visits and hospital admissions
J Am Geriatr Soc
(1991) - et al.
Referral of patients from long-term to acute-care facilities
J Am Geriatr Soc
(1983) - et al.
Patient transfer from nursing home to emergency department: Outcomes and policy implications
Acad Emerg Med
(1997) - et al.
Do Transfer records for extended care facility patients sent to the emergency department contain essential information?
Ann Emerg Med
(2001) - et al.
Improving transition and communication between acute care and long-term care: A system for better continuity of care
Ann Long-Term Care
(2005) - et al.
Improving the quality of transitional care for persons with complex care needs
J Am Geriatr Soc
(2003) Crossing the Quality Chasm: A New Health System for the 21st Century
(2001)- et al.
One patient, many places: Managing health care transitions, part I: Introduction, accountability, information for patients in transition
Ann Long-Term Care
(2004)
Emergency care for patients in long-term care facilities: A need for better communication
Acad Emerg Med
Emergency care and the patient in the long-term care facility
CMAJ
The interface between nursing homes and emergency departments: A community effort to improve transfer of information
Acad Emerg Med
An extended care facility-to-emergency department transfer form improves communication
Acad Emerg Med
Cited by (67)
Unique Care Needs of People with Dementia and Their Caregivers during Transitions from Skilled Nursing Facilities to Home and Assisted Living: A Qualitative Study
2022, Journal of the American Medical Directors AssociationFactors associated with increased Emergency Department transfer in older long-term care residents: a systematic review
2022, The Lancet Healthy LongevityDescribing Transfers Originating Out-of-Facility for Nursing Home Residents
2022, Journal of the American Medical Directors AssociationComfort Measures Orders and Hospital Transfers: Insights From the OPTIMISTIC Demonstration Project
2019, Journal of Pain and Symptom ManagementThe Impact of Incomplete Nursing Home Transfer Documentation on Emergency Department Care
2019, Journal of the American Medical Directors AssociationInvolvement of Advanced Practice Nurse in the Management of Geriatric Conditions: Examples from Different Countries
2018, Journal of Nutrition, Health and Aging
- 1
Dr Terrell is supported by a Dennis W. Jahnigen Career Development Scholars Award, which is funded by the American Geriatrics Society, the John A. Hartford Foundation, and Atlantic Philanthropies, Inc.