Implementing CARE: Comprehensive Assessment and Rapid Response for the Elderly
Alison O’Toole1, Naomi Hood-Penn1, Kelly McAuliffe1 1Osborne Park Hospital, Perth, WA, Australia
Abstract
Background
Lack of coordination with current post-discharge services highlighted the need for development of a comprehensive older adult pathway to provide targeted and coordinated intervention after an ED presentation.
Funding was secured to develop an older adult CARE program to provide a coordinated approach to supporting patients to assist with managing demand and support patient flow.
The program extended the catchment and scope of existing post-acute (and community) geriatric outpatient services, aimed to streamline pathways and encourage collaboration.
Method
The CARE program commenced in February 2022 and included a rapid access clinic, rapid response home visiting allied health and nursing team and Care Navigator role.
Program evaluation took place in October 2022 utilising data from March to September. During this period 692 patients were referred to the programs.
Results
•20% reduction in ED re-presentation rate for older adults to SCGH
•40 ED presentations were prevented, and 4 patients directly admitted to a secondary inpatient bed
•On average 0.8 day shorter length of stay for those referred to CARE vs traditional discharge pathways
•Improved co-ordination of care for community and post-acute patients measured by patient satisfaction survey
•Positive patient outcomes and reduced risk of hospital-related complications
Discussion
Initial results indicate that the CARE program enhances coordination of multidisciplinary care for frail, vulnerable community dwelling older adults who have recently been discharged from hospital or are at imminent risk of hospitalisation.
Future opportunities exist to support hospital diversion working with St John Ambulance and virtual ED initiatives.
Biography
Biographies to come