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Specialized care settings or centers are situated in convenient locations within the community and offer care to a specific group or population. They consist of daycare facilities, mental health facilities, rural health facilities, educational institutions, industries, shelters for the homeless, and rehabilitation facilities.
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A Program to Reduce Emergency Department Transfers and Build Long-Term Care Home Capacity: A Mixed-Methods Study.

Geetha Mukerji1, Leahora Rotteau2, Joanne Goldman3

  • 1Women's College Hospital Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

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Summary
This summary is machine-generated.

The Long-Term Care Plus (LTC+) program did not significantly decrease emergency department transfers, likely due to pandemic effects. However, it enhanced long-term care home capacity and self-efficacy in providing client-centered care.

Keywords:
Avoidable ED transfersLTC home capacityquality improvement

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Area of Science:

  • Gerontology
  • Health Services Research
  • Public Health

Background:

  • Transfers from long-term care homes to acute care hospitals pose risks to residents.
  • The COVID-19 pandemic highlighted the need for innovative solutions to manage resident care within long-term care settings.

Purpose of the Study:

  • To evaluate the impact of the Long-Term Care Plus (LTC+) program on reducing emergency department (ED) transfers from long-term care homes (LTCHs).
  • To explore participant perceptions and contextual factors influencing the uptake of the LTC+ program.

Main Methods:

  • A mixed-methods study was conducted across 54 LTCHs in Toronto, Canada.
  • Statistical process control charts analyzed ED transfer rates, comparing high- and low-uptake LTCHs.
  • Thematic analysis of semistructured interviews with healthcare providers, administrators, residents, and caregivers explored program experiences.

Main Results:

  • During the study period, 40% of 9658 ED transfers did not require admission.
  • The LTC+ program provided 534 virtual consultations, with 5 LTCHs accounting for 59% of usage.
  • Overall ED transfer rates decreased by 40% compared to baseline, with no significant difference between high and low LTC+ uptake facilities.

Conclusions:

  • The LTC+ program did not demonstrate a reduction in ED transfers beyond concurrent pandemic-related trends.
  • Participants reported benefits beyond ED avoidance, including increased self-efficacy and capacity within LTCHs.
  • Program refinements and structural changes are recommended to enhance the impact of LTC+ on resident care and transfer reduction.