RACE project: helping older patients get home sooner

A new Westmead Hospital program has helped more than 100 elderly patients avoid a hospital stay and get better in their own homes.

The three-month pilot program, which ran out of the hospital’s emergency department, aimed to offer elderly patients presenting to emergency, an alternative to hospital admission, enabling suitable candidates to be discharged for in-home treatment.

The results of the Rapid Access to Care and Evaluation (RACE) project, which wrapped up earlier this year, are now in – and they show a significant reduction in hospital stays for RACE patients.

Westmead Hospital geriatric medicine head Dr Ray Cabela said of the 114 patients treated under RACE, 100 were diverted from admission, allowing them to be treated in their own home.

He noted many patients were also discharged in less than five hours, freeing up vital emergency beds quicker and allowing patients to get home sooner for treatment.

The project ran from the hospital’s newly renovated Healthcare for Older People Earlier (HOPE) unit, which was refurbished as part of the Westmead Redevelopment.

Patients treated in the unit were assessed for RACE – if their injury was deemed manageable from home, they were discharged.

A multi-disciplinary team, including Westmead Hospital’s occupational therapists, physiotherapists, social workers and doctors, along with community nursing and home support services, would then visit the patient once they arrived home from hospital, offering them treatment and support, along with access to in-home mobility devices.

Dr Cabela said RACE offered a different approach to patient care.

“The program really focused on offering a more person-centered model of healthcare for older patients,” he said.

“Many patients treated under RACE would have had to be admitted to hospital if it wasn’t for the program; this way, we’ve been able to treat them in their home, where they are comfortable, and offer them follow-up in-home support.”

RACE also proved a hit with patients – of the people surveyed, 80 per cent rated it highly.

Patient Subramaniam Rajaratnam came into HOPE after falling in his bathroom.

The 83-year-old was discharged under the RACE program and treated at home.

Mr Rajaratnam’s daughter Kiri Thabapalan said the program was fantastic.

“This treatment process is just so much better,” she said.

“If he was in hospital, it would have been harder on everyone – he’s in his own house, his own environment, where he feels comfortable.

“He had so many staff coming to see him, everybody was great; I couldn’t take time off to be there all the time but the RACE team kept me regularly informed.”

The Westmead Redevelopment is transforming health infrastructure and services across the Westmead precinct, including the spaces and services used by elderly patients.

Members of project user groups (PUGs), including a HOPE PUG, have been involved in planning a 12-unit bed for older people for the new hospital building.

“We are using the Westmead Redevelopment planning process as a prism through which we look at everything we do and how to improve experiences and care of patients,” Dr Cabela said.

“There is much more to the redevelopment than just a shiny new hospital and renovated spaces.”