title: Continuity matters: Examining the 'information gap' in transfer from Residential Aged Care, ambulance to emergency triage in southern Tasmania.
abstract: BACKGROUND
  Transfer of older people from Residential Aged Care Facilities to Emergency Departments requires multiple comprehensive handovers across different services. Significant information gaps exist in transferred information despite calls for standards.
  
  
  OBJECTIVE
  To investigate: (1) presence of minimum standard elements in the transfer text written by RACF nurses, paramedics and ED triage nurses, and (2) the transfer documentation used by services.
  
  
  METHODS
  We analysed retrospective cross-sectional transfer narratives from the digital medical record system of an Australian tertiary referral hospital using the mnemonic SBAR (Situation, Background, Assessment Recommendation) as the measure of comprehensiveness. Transfer documents from 3 groups were also reviewed.
  
  
  RESULTS
  Inclusion of elements from SBAR was inconsistent across transfer. Rather, the written narratives focused on concerns relevant to the immediate priority, the type of information imposed by the document(s) in use, and clinical role of the author.
  
  
  CONCLUSIONS
  Transfer documentation from Residential Aged Care nurses, paramedics and ED triage nurses do not contain comprehensive information of older persons complex conditions. Better communication between non-affiliated organisations is needed to improve timely appropriate care for RACF residents.
authors.affiliation: University of Tasmania, Hobart, Tasmania, Australia; Royal Hobart Hospital, Emergency Department, Hobart, Tasmania, Australia. Electronic address: Briony.Campbell@utas.edu.au.
authors.forename: Briony
authors.initials: B
authors.lastname: Campbell
authors.affiliation: University of Tasmania, Hobart, Tasmania, Australia. Electronic address: Christine.Stirling@utas.edu.au.
authors.forename: Christine
authors.initials: C
authors.lastname: Stirling
authors.affiliation: University of Tasmania, Hobart, Tasmania, Australia. Electronic address: Elizabeth.Cummings@utas.edu.au.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Cummings
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000552:Ambulances / Q000592:standards; D003142:Communication; D003266:Continuity of Patient Care; D003430:Cross-Sectional Studies; D004282:Documentation / Q000379:methods / Q000592:standards*; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D062209:Patient Handoff / Q000592:standards*; D010360:Patient Transfer / Q000379:methods / Q000592:standards*; D012112:Residential Facilities / Q000592:standards; D012189:Retrospective Studies; D013648:Tasmania; D014218:Triage / Q000379:methods; D000078329:Workforce
keywords: Ambulance; Australia; Documentation; Emergency service; Hospital; Interdisciplinary communication; Retrospective studies; Triage