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Multi-facility pilot testing approach to keep residents out of hospital


A Queensland University of Technology project has secured $1.9 million to roll out a tailored staff training program in 12 aged care facilities that aims to the reduce unnecessary hospitalisations of residents.

The Early Detection of Deterioration in Elderly residents (EDDIE+) program aims to upskill aged care staff to be able to identify early signs of deterioration and prevent avoidable hospitalisations.

QUT is collaborating with CQUniversity, which piloted an earlier version of the program, EDDIE, with Queensland aged care provider PresCare in one facility in 2014.

The facility piloting EDDIE achieved a 50 percent reduction in the number of residents transferred to hospital in the first 12 months and the approach was then implemented into another PresCare facility in 2016 (read our story here).

EDDIE+ project investigator and health economist Dr Hannah Carter said they would like to deliver a similar program to the last pilot but scaled up to 12 facilities.

Dr Hannah Carter

“We’re putting in implementation science framework to do that and a focus on implementing it in such a way that could be sustainable, so it doesn’t all fall over once the research team leaves,” Dr Carter told Australian Ageing Agenda.

The program will be trialled at 12 Bolton Clarke aged care facilities in Queensland.

Adressing knowledge gaps

Dr Carter said staff would learn about the traffic-light system to identify early signs of deterioration in urinary tract infections, dehydration, constipation, chest pain, breathing difficulty, delirium, falls and palliative care.

The study addresses a knowledge gap staff may have in identifying early signs of deterioration, said Dr Carter, senior research fellow at Queensland University of Technology’s Australian Centre for Health Services Innovation.

Staff will also receive training on advanced diagnostic equipment unavailable at most aged care facilities, such as a bladder scanner and electrocardiogram machine to detect heart rhythms, Dr Carter said.

The program aims to empower nursing staff to deliver better care to residents and keep them out of the hospital.

“We know that residents who are admitted to hospital are at higher risk of picking up complications and things like infections, which can further put them at risk of deterioration or even death,” she said.

“If you can pick something up early, you can prevent more serious adverse complications down the track,” Dr Carter said.

Dr Carter said she hopes the study will generate evidence that the program is cost-effective, easy to implemented and sustainable.

The three-year study has commenced and is on track to implement and trial EDDIE+ in facilities in the second half of next year.

Minister for Health Greg Hunt announced the grant on 26 August among 10 new projects to share $11.7 million to keep Australians out of hospital.

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2 Responses to Multi-facility pilot testing approach to keep residents out of hospital

  1. Robyn D. September 14, 2019 at 10:32 am #

    Great ideas, just need to ensure that the GPs and Families of residents are on the same page, as often when this has been trailed in the past, the GPs and families all want a hospital transfer for anything out of the ordinary, whether it be a trust issue towards the home or to cover themselves. Hospital is still seen as the place to go, even though the residents often suffer confusion, anxiety and can pick up infections. Often the Nurses at the nursing home are too scared not to send, due to fear of complaints and criticism from families, management and Govt auditors, often the attitude is “pass it onto to Ambulance or Hospital to cover yourself”, speak to any Ambulance officers and they will tell you.

  2. Residential in Reach Nurse September 16, 2019 at 10:01 am #

    Victoria has had a similar program for many years called Residential in Reach. Highly trained and skilled registered nurses go into Aged Care Facilities to support staff, assess residents and liaise with their GP and Hospitals to commence tests and treatment.
    The Residential in Reach Nurses also support the staff in the Aged Care Facilities to run transfusions including blood, assist with supporting palliative care residents and complex wound care. The Residential in Reach Nurses also work with and support residents families in understanding what is happening and treatment choices available to the resident.
    This has been a very successful program in Victoria in preventing the transfer of Aged Care Residents to A&E and Hospital admissions.
    Perhaps the minister would like to increase the funding to the Victorian program to expand its hours of service in Regional and Rural Victoria?
    Families and GP’s have responded very positively to the Residential in Reach Program, the families feel they have someone who has the knowledge, skills and time to work with them and the GP’s have a small group of nurses they trust to work with.

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