All referrals completed? The issues of liaison and documentation when discharging older people from an emergency department to home

Aims. To examine key aspects of the management of the older person in preparation for discharge home from the emergency department to the primary care sector by examining the present levels and organisation of referrals. Background. Older people usually present at emergency departments in response to a medical crisis in their lives. A seamless transition across organisational boundaries is necessary for providing quality health care and to avoid fragmentation of care provision following discharge. Evidence suggests that a lack of communication, documentation and continuity of care between healthcare sectors generally exists. Design. The sample comprised the total population (n = 222) of all medical and nursing staff in the emergency department of one regional hospital and primary care area associated with it. A purposeful sample was used as some members of the primary care team were excluded from the sample. Methods. The method adopted was a survey approach which employed the use of standardised questionnaires comprising both open and closed questioning styles. Raw statistical data were analysed using spss for Windows while the qualitative data arising from the open‐ended questions were content analysed for themes. Results. The findings of this study support previous research in that older people continue to be discharged from the emergency department with inadequately determined aftercare needs and deficits in communications with the primary care sector. Conclusion. Current communication between emergency departments and the primary care sector would appear to be disjointed, indicating a need to develop effective referral criteria, accurate documentation and prompt referral. Relevance to clinical practice. Arrangements for discharge from the emergency department that incorporate effective liaison and communications between sectors will contribute to the quality of services for the older person. This will enhance the provision of more efficient aftercare and in the prevention of reoccurrence of health problems and further referral to the emergency department.