title: A structure and process evaluation of an Australian hospital admission avoidance programme for aged care facility residents.
abstract: OBJECTIVE
  To describe and evaluate the structures and processes involved in a hospital in the Nursing Home programme.
  
  
  BACKGROUND
  Older Australians are the largest consumers of healthcare, and as a result of the ageing process are at risk of developing hospital acquired iatrogenic complications. Hospital admission avoidance programmes that aim to provide care for patients in their own environment include Hospital in the Home and, more recently, Hospital in the Nursing Home.
  
  
  METHODS
  In 2006, a qualitative evaluation of a nurse-led Hospital in the Nursing Home programme using semi-structured interviews with 19 stakeholders was undertaken. Data analysis involved using start codes and content analysis.
  
  
  RESULTS
  Effective referral and communication strategies were important for Hospital in the Nursing Home implementation. Furthermore, the Hospital in the Nursing Home programme manager had acute care and community experience and worked in an advanced practice role. These elements were integral to the programme's operation.
  
  
  CONCLUSIONS
  As the population ages, reducing hospital admissions for aged-care facility residents has the potential to improve patient outcomes. A structurally and procedurally sound programme is a key element in achieving this aim.
authors.affiliation: Emergency Department Clinical Network, Queensland Health and Research Centre for Clinical and Community Practice Innovation, Griffith University, Gold Coast, Australia. julia_crilly@health.qld.gov.au
authors.forename: Julia
authors.initials: J
authors.lastname: Crilly
authors.forename: Wendy
authors.initials: W
authors.lastname: Chaboyer
authors.forename: Marianne
authors.initials: M
authors.lastname: Wallis
mesh_terms: D000328:Adult; D057179:Advanced Practice Nursing; D000368:Aged; D000375:Aging / Q000502:physiology; D001315:Australia; D002983:Clinical Competence; D019091:Critical Pathways; D004636:Emergency Service, Hospital / Q000458:organization & administration; D006299:Health Services for the Aged / Q000458:organization & administration*; D018575:Home Care Services, Hospital-Based / Q000458:organization & administration*; D006760:Hospitalization; D006801:Humans; D008875:Middle Aged; D024802:Nurse's Role; D015403:Nursing Evaluation Research; D009735:Nursing Homes; D011157:Population Dynamics; D017064:Process Assessment, Health Care; D015397:Program Evaluation; D036301:Qualitative Research; D012017:Referral and Consultation / Q000458:organization & administration