Fractured Care: A Window Into Emergency Transitions in Care for LTC Residents With Complex Health Needs
Objective: For long-term care (LTC) residents, transfers to emergency departments (EDs) can be associated with poor health outcomes. We aimed to describe characteristics of residents transferred, factors related to decisions during transfer, care received in emergency medical services (EMS), ED sett...
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| Veröffentlicht in: | Journal of aging and health 2020-03, Vol.32 (3-4), p.119-133 |
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| container_title | Journal of aging and health |
| container_volume | 32 |
| creator | Cummings, Greta G. McLane, Patrick Reid, R. Colin Tate, Kaitlyn Cooper, Sarah L. Rowe, Brian H. Estabrooks, Carole A. Cummings, Garnet E. Abel, Stephanie L. Lee, Jacques S. Robinson, Carole A. Wagg, Adrian |
| description | Objective: For long-term care (LTC) residents, transfers to emergency departments (EDs) can be associated with poor health outcomes. We aimed to describe characteristics of residents transferred, factors related to decisions during transfer, care received in emergency medical services (EMS), ED settings, outcomes on return to LTC, and times of transfer segments along the transition. Method: We prospectively followed 637 transitions to an ED in British Columbia and Alberta, Canada, over a 12-month period. Data were captured through an electronic Transition Tracking Tool and interviews with health care professionals. Results: Common events triggering transfer were falls (26.8%), sudden change in condition (23.5%), and shortness of breath (19.8%). Discrepancies existed between reason for transfer, EMS reported chief complaint, and ED diagnosis. Many transfers resulted in resident return directly to LTC (42.7%). Discussion: Avoidable transfers may put residents at risk of receiving inappropriate care. Standardized communication strategies to highlight changes in resident condition are warranted. |
| doi_str_mv | 10.1177/0898264318808908 |
| format | Article |
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Colin ; Tate, Kaitlyn ; Cooper, Sarah L. ; Rowe, Brian H. ; Estabrooks, Carole A. ; Cummings, Garnet E. ; Abel, Stephanie L. ; Lee, Jacques S. ; Robinson, Carole A. ; Wagg, Adrian</creator><creatorcontrib>Cummings, Greta G. ; McLane, Patrick ; Reid, R. Colin ; Tate, Kaitlyn ; Cooper, Sarah L. ; Rowe, Brian H. ; Estabrooks, Carole A. ; Cummings, Garnet E. ; Abel, Stephanie L. ; Lee, Jacques S. ; Robinson, Carole A. ; Wagg, Adrian</creatorcontrib><description>Objective: For long-term care (LTC) residents, transfers to emergency departments (EDs) can be associated with poor health outcomes. We aimed to describe characteristics of residents transferred, factors related to decisions during transfer, care received in emergency medical services (EMS), ED settings, outcomes on return to LTC, and times of transfer segments along the transition. Method: We prospectively followed 637 transitions to an ED in British Columbia and Alberta, Canada, over a 12-month period. Data were captured through an electronic Transition Tracking Tool and interviews with health care professionals. Results: Common events triggering transfer were falls (26.8%), sudden change in condition (23.5%), and shortness of breath (19.8%). Discrepancies existed between reason for transfer, EMS reported chief complaint, and ED diagnosis. Many transfers resulted in resident return directly to LTC (42.7%). Discussion: Avoidable transfers may put residents at risk of receiving inappropriate care. Standardized communication strategies to highlight changes in resident condition are warranted.</description><identifier>ISSN: 0898-2643</identifier><identifier>EISSN: 1552-6887</identifier><identifier>DOI: 10.1177/0898264318808908</identifier><identifier>PMID: 30442040</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Aged ; Aged, 80 and over ; Alberta ; British Columbia ; Emergency Service, Hospital ; Female ; Health technology assessment ; Humans ; Long-Term Care ; Male ; Prospective Studies ; Residential Facilities ; Transitional Care - organization & administration</subject><ispartof>Journal of aging and health, 2020-03, Vol.32 (3-4), p.119-133</ispartof><rights>The Author(s) 2018</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c365t-1779d4c8326b388f4db9737a6d733f7de1d427b4d90300f5c5589e63eafb93833</citedby><cites>FETCH-LOGICAL-c365t-1779d4c8326b388f4db9737a6d733f7de1d427b4d90300f5c5589e63eafb93833</cites><orcidid>0000-0002-3711-7515</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0898264318808908$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0898264318808908$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30442040$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cummings, Greta G.</creatorcontrib><creatorcontrib>McLane, Patrick</creatorcontrib><creatorcontrib>Reid, R. Colin</creatorcontrib><creatorcontrib>Tate, Kaitlyn</creatorcontrib><creatorcontrib>Cooper, Sarah L.</creatorcontrib><creatorcontrib>Rowe, Brian H.</creatorcontrib><creatorcontrib>Estabrooks, Carole A.</creatorcontrib><creatorcontrib>Cummings, Garnet E.</creatorcontrib><creatorcontrib>Abel, Stephanie L.</creatorcontrib><creatorcontrib>Lee, Jacques S.</creatorcontrib><creatorcontrib>Robinson, Carole A.</creatorcontrib><creatorcontrib>Wagg, Adrian</creatorcontrib><title>Fractured Care: A Window Into Emergency Transitions in Care for LTC Residents With Complex Health Needs</title><title>Journal of aging and health</title><addtitle>J Aging Health</addtitle><description>Objective: For long-term care (LTC) residents, transfers to emergency departments (EDs) can be associated with poor health outcomes. 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Standardized communication strategies to highlight changes in resident condition are warranted.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Alberta</subject><subject>British Columbia</subject><subject>Emergency Service, Hospital</subject><subject>Female</subject><subject>Health technology assessment</subject><subject>Humans</subject><subject>Long-Term Care</subject><subject>Male</subject><subject>Prospective Studies</subject><subject>Residential Facilities</subject><subject>Transitional Care - organization & administration</subject><issn>0898-2643</issn><issn>1552-6887</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUtLxDAUhYMoOj72riTgxk01rzaJOynjAwYFGXFZ0uZ2rLTJmLSo_96O4wMEV7nhfOfc5F6EDik5pVTKM6K0YpngVKmxJGoDTWiasiRTSm6iyUpOVvoO2o3xmRDCKKHbaIcTIRgRZIIWl8FU_RDA4twEOMcX-LFx1r_iG9d7PO0gLMBV73gejItN33gXceM-YVz7gGfzHN9DbCy4Po7e_gnnvlu28IavwbTj9RbAxn20VZs2wsHXuYceLqfz_DqZ3V3d5BezpOJZ2ifjp7QVleIsK7lStbClllyazErOa2mBWsFkKawmnJA6rdJUacg4mLrUXHG-h07WucvgXwaIfdE1sYK2NQ78EAtGeUqZ1lKM6PEf9NkPwY2vKxhPGddEihVF1lQVfIwB6mIZms6E94KSYrWE4u8SRsvRV_BQdmB_DN9TH4FkDUSzgN-u_wZ-AG8RjB4</recordid><startdate>202003</startdate><enddate>202003</enddate><creator>Cummings, Greta G.</creator><creator>McLane, Patrick</creator><creator>Reid, R. 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Colin</au><au>Tate, Kaitlyn</au><au>Cooper, Sarah L.</au><au>Rowe, Brian H.</au><au>Estabrooks, Carole A.</au><au>Cummings, Garnet E.</au><au>Abel, Stephanie L.</au><au>Lee, Jacques S.</au><au>Robinson, Carole A.</au><au>Wagg, Adrian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Fractured Care: A Window Into Emergency Transitions in Care for LTC Residents With Complex Health Needs</atitle><jtitle>Journal of aging and health</jtitle><addtitle>J Aging Health</addtitle><date>2020-03</date><risdate>2020</risdate><volume>32</volume><issue>3-4</issue><spage>119</spage><epage>133</epage><pages>119-133</pages><issn>0898-2643</issn><eissn>1552-6887</eissn><abstract>Objective: For long-term care (LTC) residents, transfers to emergency departments (EDs) can be associated with poor health outcomes. We aimed to describe characteristics of residents transferred, factors related to decisions during transfer, care received in emergency medical services (EMS), ED settings, outcomes on return to LTC, and times of transfer segments along the transition. Method: We prospectively followed 637 transitions to an ED in British Columbia and Alberta, Canada, over a 12-month period. Data were captured through an electronic Transition Tracking Tool and interviews with health care professionals. Results: Common events triggering transfer were falls (26.8%), sudden change in condition (23.5%), and shortness of breath (19.8%). Discrepancies existed between reason for transfer, EMS reported chief complaint, and ED diagnosis. Many transfers resulted in resident return directly to LTC (42.7%). Discussion: Avoidable transfers may put residents at risk of receiving inappropriate care. 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| subjects | Aged Aged, 80 and over Alberta British Columbia Emergency Service, Hospital Female Health technology assessment Humans Long-Term Care Male Prospective Studies Residential Facilities Transitional Care - organization & administration |
| title | Fractured Care: A Window Into Emergency Transitions in Care for LTC Residents With Complex Health Needs |
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