Avoiding Unnecessary Hospital Transfers From Nursing Homes

View from ground floor up. Hospital bed on wheels in corridor. h

A study published in the Journal of the American Geriatrics Society has shed some light on what nursing homes can do to reduce unnecessary transfers from nursing homes to hospital emergency departments.

“Transfers of care can be very difficult on the patient. Our goal in analyzing this data is to identify new opportunities to improve care, whether it’s preventing transfers to the emergency department or finding ways to avoid hospital admissions,” said Kathleen Unroe, M.D., MHA, first author of the paper and associate professor of medicine at IU School of Medicine. “This information helps us understand what ailments could potentially be treated in the nursing home, avoiding a potentially risky transfer of care.”

That “potentially risky transfer of care” is attributed with thousands of additional injuries to elderly patients a year. In transfers, either from nursing homes to hospitals, or between hospitals, elderly patients face significantly higher mortality rates and cases of injury. Too-frequent transfers have even been tied to an increased risk for new-onset delirium. Obviously, transferring elderly patients that might not ultimately need to be transferred is a problem that needs solving.

The research team in the AGS study looked at 800 nursing home facility residents enrolled in the OPTIMISTIC project. OPTIMISTIC (Optimizing Patient Transfers, Impacting Medical quality, Improving Symptoms—Transforming Institutional Care) was a demonstration project funded by the Centers for Medicare and Medicaid aimed at reducing potentially avoidable hospitalizations of people in nursing homes.

What Types of Geriatric Issues Can Avoid Emergency Room Visits?

The study published in AGS showed that frequently, certain types of injuries were treated directly in the emergency room instead of admitting the patient into the hospital. These injuries could be treated directly in the nursing home if the nursing home staff have the proper training and equipment:

  • Fractured bones
  • Sprained ligaments
  • Trauma from falls
  • External bleeding
  • Tolerable pain

Issues with any of these were shown to largely not require hospital admittance, resulting in a potentially unnecessary hospital transfer. This unnecessary transfer put avoidable trauma and stress on the elderly patients, harming rather than helping.

Avoiding Unnecessary Hospital Transfers For Geriatric Patients

The conclusion of the AGS researchers is that nursing home staff should have the training and expertise to handle minor issues with elderly patients. Transferring an elderly patient unnecessarily can cause greater stress and trauma on the patient than even the initial injury. It is the responsibility of a nursing home to adequately train their staff on these findings, as knowing the difference between a justified and unjustified hospital transfer could save thousands of nursing home residents from excessive tension and difficulty.

If you believe your elderly loved one has suffered injury or trauma as a result of an unnecessary hospital transfer, please contact Berberian Ain LLP for a free consultation.