title: Communication between residential aged care facilities and the emergency department: a review of the literature.
abstract: BACKGROUND
  Western countries have encountered an increase in elderly patients transferred from residential aged care facilities to emergency departments. This patient cohort frequently experiences impaired physical and cognitive function. Emergency department staff require important clinical and personal patient information to provide quality care. International studies show that documentation and handover deficiencies are common.
  
  
  OBJECTIVE
  The purpose of this literature review was to explore transitional communication practices, and to consider the specific patient information deemed essential for the management of residents in the emergency department.
  
  
  METHODS
  A literature review was conducted to examine the studies exploring the documentation accompanying elderly people who were transferred from residential aged care facilities to emergency departments. Scopus, OVID Medline and Cinahl Plus data bases were searched using combinations of the following key words: 'nursing home', 'long-term care', 'skilled nursing facility', 'aged care facility', 'communication', 'documentation', 'emergency department', 'emergency room', 'hospital', 'acute', 'transfer', and 'transition'. Additional data was located with the use of Google Scholar. Review of titles and exclusion of duplicates identified 69 relevant studies. These 69 papers were independently reviewed by three members of the research team for eligibility for inclusion in the review, and seven papers were retained.
  
  
  RESULTS
  There is currently no consensus regarding what information is essential when residents are transferred from aged care facilities to emergency departments, and practices vary. Key information which should accompany the resident has been reported by various authors and include the reason for transfer, past medical history, current medications, cognitive function and advance directives. Some authors also suggest that facility contact details are essential. Without agreement by key stakeholders as to what constitutes 'essential transfer information', clinical practices will continue to vary and resident care will be affected.
  
  
  CONCLUSIONS
  This paper identifies frequent communication deficits in the information provided to the emergency department from aged care facilities. There is an imperative to identify suitable items of information which health care professionals agree are essential. Future research should focus on methods to improve the transfer of information between facilities, including consensus regarding what information is essential transfer data.
authors.affiliation: School of Nursing and Midwifery, Monash University, P.O. Box 527, Frankston 3199, Australia. Electronic address: debra.griffiths@monash.edu.
authors.forename: Debra
authors.initials: D
authors.lastname: Griffiths
authors.affiliation: School of Nursing and Midwifery, Monash University, P.O. Box 527, Frankston 3199, Australia.
authors.forename: Julia
authors.initials: J
authors.lastname: Morphet
authors.affiliation: School of Nursing and Midwifery, Monash University, P.O. Box 527, Frankston 3199, Australia.
authors.forename: Kelli
authors.initials: K
authors.lastname: Innes
authors.affiliation: School of Nursing and Midwifery, Monash University, P.O. Box 527, Frankston 3199, Australia.
authors.forename: Kimberley
authors.initials: K
authors.lastname: Crawford
authors.affiliation: School of Nursing and Midwifery, Monash University, P.O. Box 527, Frankston 3199, Australia.
authors.forename: Allison
authors.initials: A
authors.lastname: Williams
mesh_terms: D003142:Communication; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006707:Homes for the Aged / Q000458:organization & administration*; D007373:Interinstitutional Relations
keywords: Aged care; Communication; Emergency nursing; Quality of care; Transfer documentation