Can transfers from residential aged care facilities to the Emergency Department be avoided through improved primary care services? Data from qualitative interviews

Aim: To explore the factors that influence the transfer of patients from residential aged care facilities (RACF) to hospital emergency departments (ED), and describe features of improved primary care in RACF that could result in reduced transfer. Methods: a. Three focus groups conducted with family and carers of RACF residents, along with RACF, ED and general practice staff. b. Semistructured one-on-one interviews with nine residents of RACF. Results: Five main themes emerged - staffing and skill mix in RACF, treatment options in RACF, end of life decision-making, communication and bureaucratic requirements. Analysis of the semistructured interviews demonstrated parallel concerns with many of the focus groups indicators. There was a strong but not universal preference among residents to minimise RACF to ED transfer. Conclusions: The transfer of residents from RACF to ED is influenced by multiple interrelated factors, and strategies to reduce transfer should address these.