Identifying Appropriate Nursing Home Resources to Reduce Fall-Related Emergency Department Transfers

Area of Science:

• Gerontology
• Healthcare Management
• Patient Safety

Background:

• Fall-related transfers from nursing homes to emergency departments (EDs) represent a significant burden on healthcare systems.
• Identifying potentially avoidable transfers is crucial for improving resident care and optimizing resource allocation.

Purpose of the Study:

• To describe potentially avoidable fall-related transfers to the ED from nursing homes (NHs).
• To identify appropriate infrastructure, training needs, and resources for NHs to decrease these transfers.

Main Methods:

• A multi-method design involving expert panel case reviews, stakeholder discussions, and appropriateness ratings.
• Analysis of 81 fall-related transfers over 21 months from 11 Swiss NHs.
• Utilized χ² tests and the RAND/UCLA appropriateness method.

Main Results:

• One in four fall-related transfers were rated as potentially avoidable.
• A significant association was found between transfer avoidability and ED visits (P < .001).
• Fourteen resources, including partnerships for imaging and enhanced geriatric expertise, were deemed appropriate for NH implementation.

Conclusions:

• Access to diagnostic equipment, geriatric expertise, and clinical training are vital for reducing avoidable fall-related transfers.
• Implementing advanced practice nurses can help re-engineer resources to limit unnecessary transfers, improving resident care and reducing costs.