How virtual care is reducing emergency admissions of western Sydney aged care residents
Western Sydney Local Health District (WSLHD) inTouch team members are helping to keep residential aged care facility (RACF) residents with acute health concerns out of hospital by offering direct access to specialist advice via telehealth.
The inTouch service provides a central point of contact for RACF staff, GPs, paramedics, hospital staff, and health and community service providers to collaborate via digital platforms with the aim of providing the best quality of care to residents where they live, rather than in an unfamiliar environment.
inTouch was founded in 2021 by WSLHD Integrated and Community Health to support at-home care for COVID-19 patients, and following the success and ongoing potential of this innovative telehealth model, commenced the clinical coordination of RACF residents in April 2022. Aligned with the District’s strategic priorities, this model of care aims to prevent unnecessary Emergency Department (ED) transfers and provides care setting options for a resident.
From 1 April to 14 November 2022, the service received 1787 referrals and avoided 441 ED hospital transfers due to inTouch intervention.
One of the biggest benefits of the service is “by allowing RACF residents to be medically managed in a familiar environment, residents feel more at ease”, says WSLHD self-management support clinical nurse consultant Melanie Talbot.
WSLHD inTouch medical lead Dr Benson Riddle said one case recently involving a RACF resident with ongoing wrist pain following a fall the previous day highlights the effectiveness of the service.
“The resident’s GP had arranged a mobile X-ray, but RACF staff were unable to access the result when the GP was unavailable, so they called an ambulance to arrange a transfer to ED for further management,” said Benson.
“At this point, inTouch reached out to assist and was able to access the resident’s X-ray images via the mobile radiology’s secure online portal and shared these with the orthopaedic team on-call at Westmead Hospital who recommended six-weeks immobilisation of the fracture.
After liaising with NSW Ambulance, an Extended Care Paramedic was sent out to the RACF to apply a plaster in the comfort of the resident’s own bed, just as they would have in ED.”
Nelly Banag, general manager of Moran Aged Care in Kellyville, contacted the inTouch service about patient medical coordination four times last month.
“The inTouch service has been very useful as our clinical staff can have difficulty getting medical advice to confirm our opinion about our residents’ medical issues and it can be difficult to access after-hours GP services,” said Nelly.
“It is good to have another service available for our Registered Nurses to refer to and to avoid residents unnecessarily attending hospital – residents get confused when transferred to the emergency department and often don’t want to go.”
Examples of the types of care delivered in the RACF in collaboration with Hospital in the Home (HiTH) and geriatric outreach services include the clinical assessment and care for health concerns such as urinary tract infections, complex wounds and catheter management, the delivery of intravenous therapies and antibiotics and the linking of residents to community-based services.
“RACF’s across western Sydney are becoming more engaged and we are getting good feedback from their staff who report the service is simple to use and they really appreciate inTouch support and communication,” said WSLHD chronic care program nurse unit manager Katia Joseph.
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