[The effect of an intervention on rates of nursing home residents transfers to emergency departments].
BACKGROUND
Transfers of nursing home residents to emergency departments can result in iatrogenic complications, morbidity, and excess health care expenditure. Some of these transfers are potentially avoidable.


OBJECTIVE
To determine the rate of emergency department transfers of nursing home residents, prior to and following an intervention program that includes a set of tools and strategies designed to reduce these transfers.


METHODS
The present study was conducted in four departments at the Shfaram Geriatric Center (Beet Alenaya). The rate of emergency department transfers was determined in 118 residents of the nursing home during the 12 months prior to and during the 12 months following implementation and initiation of the intervention.


RESULTS
Following the intervention, a significant reduction in the rate of emergency department transfers was observed in the study population from 2.61 to 1.28 transfers per 1,000 stay days, with a 50.1% transfer reduction (P < 0.005). The most significant reduction was observed among residents staying in the Complex Nursing Care Department (54.7%)(P < 0.05). The reduction rate among long term nursing care residents was modest (20.3%) and did not reach statistical significance.


CONCLUSIONS
The implementation of such an intervention can reduce the rate of transfers of nursing home residents to emergency departments. Such interventions might lead to quality improvement in nursing homes and should be further evaluated in larger randomized controlled trials.
Efraim
E
Aizen
Eman
E
Hindawi
Hatim
H
Shahla
Ahmad Abu
AA
Elyounes
D000368:Aged; D061345:Early Medical Intervention / Q000379:methods / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006707:Homes for the Aged / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D007557:Israel; D009735:Nursing Homes / Q000592:standards / Q000706:statistics & numerical data; D010043:Outcome and Process Assessment, Health Care; D010360:Patient Transfer / Q000379:methods / Q000458:organization & administration*; D015397:Program Evaluation; D058996:Quality Improvement