Nursing Home Transfers
Important Note
Good Practice
Emerg physicians complain that it is time-consuming to call nursing homes to gather information. Sitting on-hold for a few minutes in order to get an accurate history about a complex patient and a clear sense of patient and family expectations from a first-hand observer is probably more time- and resource-efficient than ordering a lot of unnecessary tests or interventions – or missing an important diagnosis.
Departures from nursing homes are usually arranged emergently about a perceived rapid change in condition by staff who are not familiar with medical emergencies. Keeping that in mind during your conversation may improve the quality of the conversation.
If you work in an ED setting that receives most nursing home transfers from one or two institutions, it can be efficient to arrange a meeting with the medical and nursing directors to address improved strategies.
Important Note
In order to ensure high-quality ongoing care for the patient – and to avoid early ED return – it is essential to communicate back to the nursing home, on paper or electronically:
- the results of investigations (bloodwork, imaging)
- new diagnoses,
- changes of medications,
- a care plan.
Return of Patient to Nursing Home
Not surprisingly it is a perennial complaint from nursing home staff – MD and Nursing – that inadequate information is transferred back to them regarding the patient’s in-hospital care.
Ideally an attempt should be made to involve next-of-kin or powers of attorney if not present in this communication to ensure that all decision-makers are aware of the plan.
Some EDs have developed protocols for return-to-nursing home, including the requirement of a nurse-to-nurse phone call – like any in-hospital transfer. For an example of an Emergency Department Transfer Report for Long Term Care Patients, click here.
Discussion: Nursing Home Transfers
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Reaching NSG home staff can be challenging
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Improved communication may help you get a better history for the patient and lead to better care in the hospital setting.
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very true
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agreed
i have had many conversations with NH staff and in my experience they do not really know much about their patient.
best nursing practice can find underlying cause
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Make sure the receiving facility receives pertinent information.
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communication is key
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i agree it is time consuming but time well spent getting the information also sending information back to the referring source
times plays a big role in care
more time better care
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Phone report back to nursing facility is key.
i will do this
Good communication
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Good information
this area is improving for us
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good practice information
okay
good points to note
good point but its never a few minutes its more like an hour etc..
very good points
Muy importante la comunicación para el posterior seguimiento d l plan de medicamentos y cuidado del paciente
order of assessments
communicating is important to ensure care of pt.
good
great points
complete health history/ assessment
contact nursing home for complete health history
important to speak to the nursing home both before and after care
Interfacility communication is paramount in successful discharges, prevention of premature return to hospital, and general good practice for patient care.
Takes a long time but you have to do it
It is particularly frustrating in our ED that we no longer have access to EMS reports in a timely fashion. I used to read them all the time, and agree that they often provided really useful information.
All comes back to communication.
agree
communication is a must
nurse to nurse communication when discharging back to the nsg home for best care of our elderly
i repeat its very important communication whit family
es importante siempre tratar de tener la mejor información de fuentes confiables
la enfermera es un pilar
Important to have good communication with care givers and family members.
ppp
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thoroughness
xxx
wwvv
Communication between healthcare providers is essential and should be patient oriented.
really like the transfer to LTC resource tool for communicating with the staff.
The same principles of communication apply to all complex patients, not just LTC! LTC is relatively easy as there is, at least, someone to communicate with.
This is an excellent course so far…very motivating to provide better care for our elderly patients!
the institution where I work all notes from the visit are send with the patient back plus call is make before the patient leave to ensure continuing of care.
i agree it is time consuming but time well spent getting the information also sending information back to the referring source