title: Can transfers from residential aged care facilities to the emergency department be avoided through improved primary care services? Data from qualitative interviews.
abstract: OBJECTIVE
  To explore the factors that influence the transfer of patients from residential aged care facilities (RACF) to hospital emergency departments (ED), and describe features of improved primary care in RACF that could result in reduced transfer.
  
  
  METHODS
  a. Three focus groups conducted with family and carers of RACF residents, along with RACF, ED and general practice staff. b. Semistructured one-on-one interviews with nine residents of RACF.
  
  
  RESULTS
  Five main themes emerged--staffing and skill mix in RACF, treatment options in RACF, end of life decision-making, communication and bureaucratic requirements. Analysis of the semistructured interviews demonstrated parallel concerns with many of the focus groups indicators. There was a strong but not universal preference among residents to minimise RACF to ED transfer.
  
  
  CONCLUSIONS
  The transfer of residents from RACF to ED is influenced by multiple interrelated factors, and strategies to reduce transfer should address these.
authors.affiliation: Centre for Clinical Research in Emergency Medicine, Western Australian Institute for Medical Research and University of Western Australia, Perth, Western Australia, Australia. glenn.arendts@uwa.edu.au
authors.forename: Glenn
authors.initials: G
authors.lastname: Arendts
authors.forename: Tracy
authors.initials: T
authors.lastname: Reibel
authors.forename: Jim
authors.initials: J
authors.lastname: Codde
authors.forename: Jackie
authors.initials: J
authors.lastname: Frankel
mesh_terms: D000368:Aged; D004636:Emergency Service, Hospital; D005260:Female; D006299:Health Services for the Aged; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D009735:Nursing Homes; D010360:Patient Transfer; D011320:Primary Health Care