title: Bringing back the house call: how an emergency mobile nursing service is reducing avoidable emergency department visits for residents in long-term care homes.
abstract: Avoidable emergency department (ED) visits are a source of clinical risk, stress and anxiety for older, more vulnerable patients. The complexity of health conditions and the unique challenges associated with the care of older patients can also contribute to overcrowding and longer wait times in EDs--issues of significant concern for both healthcare providers and patients. Generally, older patients are more likely than younger patients to visit EDs and be admitted to hospital. In addition, older adults living in long-term care (LTC) homes are more likely to be transferred to EDs for preventable issues than those living in other settings. This paper describes how mobilizing a team of registered nurses working at full scope of practice might reduce the number of avoidable transfers of older patients to the ED. Utilizing nurses in this capacity demonstrates how the nursing profession can drive systemwide change to improve care between healthcare sectors for older adults.
authors.affiliation: Toronto General Hospital, Toronto, ON. annabelle.bandurchin@uhn.on.ca
authors.forename: Annabelle
authors.initials: A
authors.lastname: Bandurchin
authors.forename: Mary Jane
authors.initials: MJ
authors.lastname: McNally
authors.forename: Mary
authors.initials: M
authors.lastname: Ferguson-Paré
mesh_terms: D000367:Age Factors; D000465:Algorithms; D002170:Canada; D003657:Decision Making; D016529:Emergency Nursing / Q000379:methods* / Q000458:organization & administration; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006296:Health Services / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006792:House Calls; D006801:Humans; D008134:Long-Term Care / Q000379:methods* / Q000458:organization & administration; D008952:Mobile Health Units / Q000458:organization & administration*; D015403:Nursing Evaluation Research; D010865:Pilot Projects; D019564:Unnecessary Procedures / Q000379:methods* / Q000706:statistics & numerical data