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

Study 3

Prospective Cohort Study

The aim of Study 3 is to audit current practice through a prospective cohort study involving process mapping of the demographic and clinical profile, care pathways in the ED/AMU and post-discharge, re-presentation risk prediction screening tool completion and health outcomes of patients aged ≥65 years at the time of their index emergency presentation and post-discharge for six months.

This study is a prospective cohort study involving process mapping of the demographic and clinical profile of patients, care pathways through the ED/AMU and post-discharge, re-presentation risk prediction screening tool completion and health outcomes of patients aged ≥65 years at the time of their index emergency presentation and post-discharge for six months.
The target population is all older emergency patients (aged ≥65 years) presenting to the Alfred ED/AMU and discharged within 48 hours. Potential participants will be identified by the ED/AMU Physician after the patient’s medical needs have been attended to. Every effort will be made to include patients who do not have English as their first language through the use of an interpreter / English-speaking family member.

Patients will be evaluated at the time of presentation to the Alfred, and then followed up by telephone at seven days (1 week), 30 days (1 month), and 180 days (6 months) post-discharge from the Alfred to obtain information about their health outcomes, experiences and healthcare and community service utilisation since discharge from the Alfred. Details of patients’ nominated family member or person/carer and the patient’s general practitioner (GP) will be obtained at the time of recruitment in the Alfred ED/AMU to minimise loss to follow-up.

To allow for a representative sample of all older patients presenting for emergency care to the Alfred and to allow for seasonal and daily variation, 1000  patients will be recruited over a 12 month period:

  • during each season (Summer, Autumn, Winter and Spring) n=250 per season;
  • including capture throughout the day (0800 to 2100), and
  • all days of the week (Monday – Sunday).