Determining best practice for safe discharge of the older emergency patient.

PROJECT RATIONALE

The increasing burden on acute hospital care and patient flow as a result of the persistent rise in demand for emergency services by older patients is unsustainable. Present management of this vulnerable population is sub-optimal and not evidence-based. The Safe Elderly Emergency Discharge (SEED) project expects to identify groups of older patients who remain particularly at risk of unplanned re-presentation and death despite the current initiatives; and for which novel interventions, care practices and resources should be developed. As such SEED represents an investigation of the effectiveness of current practice including a care-gap analysis.

In addition to improved health outcomes of older patients, SEED’s findings are also likely to facilitate reduced emergency length of stay (LOS) and improved patient experience for older patients presenting acutely to hospital. This will have the flow-on effect of reducing demand on hospital emergency services, overcrowding and bed access/occupancy; thereby improving patient flow. This project therefore aligns with key State and National health reform priorities.

SEED provides an opportunity to provide constructive solutions. The SEED team is a collaboration that is uniquely suited to undertake this work. SEED seeks to combine research and clinical expertise to provide robust information that has the potential to improve the outcomes of older people presenting to hospital for emergency care. We anticipate that SEED will reduce unplanned emergency re-presentations and unplanned deaths in older people. This represents an improvement in health outcomes in this older more vulnerable group of patients.

The SEED findings will be disseminated through publication of papers in high-quality peer-reviewed journals and presentations at national and international conferences. This will assist in the benefits of this project being realised in older patients presenting to EDs worldwide.