Evaluation of the Use of an Intervention by Health Care Providers for Resident Transfers from Long-Term Care to Emergency Departments in Times of Medical Urgency: A Qualitative Study.

Abstract

Approximately 25% of older adult residents who experience an acute change in health status are transferred from Long-Term Care (LTC) to Emergency Departments (ED). We explored the use of an intervention (i.e., LTC to ED) care and referral pathway, INTERACT® Change in Condition cards, and STOP AND WATCH tool, in informing decision making regarding resident transfers. We conducted 22 semi-structured interviews with Health care Providers (HCPs) involved in the LTC to ED care pathway in Western Canada. Thematic analysis of the qualitative interviews was used to evaluate the use of the pathway and tools. We identified six themes influencing decision making around resident transfers including interprofessional practice and conflict, ambiguous and clear medical cases, ageism, health care providers' goals, family involvement in resident care, and intervention tools. The intervention may be useful in streamlining, documenting, and increasing transparency in complicated LTC resident care and transfer decisions.