Emergency Department Discharges Following Falls in Residential Aged Care Residents: A Scoping Review

Background: Falls in residential aged care facilities (RACFs) have a significant impact, often leading to costly and unnecessary emergency department (ED) transfers. This scoping review examined the ED discharge proportions and patient characteristics of RACF residents presenting to the ED following a fall, to identify factors that could reduce unnecessary ED transfers. Methods: The databases MEDLINE, CINAHL, Scopus, and Web of Science were searched, resulting in an initial 1385 articles. Nine of these articles met the inclusion criteria and were included in this review. Results: The median age of patients reported in the nine papers ranged from 80.8 to 88 years. Discharge proportions from ED back to RACF ranged from 36% to 91%, with an average of 63%. The studies that reported on computed tomography of the brain (CTB) showed that CTB findings did not significantly influence discharge decisions. Conclusions: Many RACF residents transferred to EDs following falls are discharged without hospital admission. The heterogeneity of study methods makes it challenging to draw definitive conclusions about factors that may help identify patient groups that do not require transfer to the ED following a fall. However, this scoping review highlights potential opportunities to reduce ED transfers from RCAFs. These findings highlight a need for geriatric-specific, person-centred protocols that reduce unnecessary ED transfers while safeguarding quality of care and respecting residents' advance care preferences.