Unplanned Resident Transfers in Residential Aged Care Homes - Wellington Park Private Care

Each quarter a considerable proportion of residents are transferred from residential aged care homes to emergency departments in hospitals. Common reasons for unplanned resident transfers include following a fall, and the presence of comorbidities such as chronic airways disease, congestive cardiac failure, and diabetes, which may result in a number of adverse outcomes for residents. Rates of transfer from residential aged care facilities to hospital can vary considerably between different RACFs and the QPS Benchmarking data demonstrates there is a 3% higher unplanned transfer rate for Homes with residents that have complex comorbidities and higher care needs.

Summary and Results

Wellington Park Private Care recognise the increased risks involved in transferring residents to acute care facilities, and the benefits to all involved in reducing the need for burdensome transfer to the emergency department. Developing and building strong relationships with local health care providers is also an added benefit when working towards common goals. The clinical team at Wellington Park Private Care have been working hard on reducing the unplanned transfers by 18% over a nine-month period and there has been a huge focus on good communication, ongoing daily education, providing staff support and direction on clinical decision making which we feel has played a dominant role in improving our clinical processes.

A 3% higher unplanned transfer rate for homes with residents that have complex comorbidities & higher care needs

A huge emphasis has been placed on staff education and the presence of the CNC on the floor daily has contributed to RN follow up of care issues/priorities and compliance. The following points provide a summary of practical strategies that have been implemented to successfully minimise resident transfers.

• CNC works closely with the RNs and care staff on the floor.
• CNC reviews residents on the floor as soon as she arrives.   Residents unwell or those who have returned from hospital the CNC consults with the RN and plans are set in motion.  Strategies are developed to aid in their recovery.  CNC continually advises the RN and is available for support.
• Over the hot months education on nutrition and hydration was rolled out to all our staff.
• Education on wound management was heavily targeted from hand washing to selecting the correct wound product and secondary dressing.  Improving RN wound assessment skills and knowledge.
• CNC works with the RNs to assist them with improving their assessment skills recognising the early signs and symptoms, developing strategies to minimise the risk of deterioration or sending the resident to hospital unnecessarily.
• CNC will use the care pact guidelines or advice via phone from care pact.  CNC currently working on RNs to use the team more efficiently.
• CNC attends shift handovers to touch base with the night staff RN/AIN’s completing education.
• We are improving our advanced care planning process.  Ensuring our families/EPOA fully understand what is involved and supporting families in their decisions.  Ensuring the documentation is correct and in place for our staff to access. 

Mary Riki-Wilkes, Head of Care