Rahja Miia, Collyer Sarah, Lynch Elizabeth, Harvey Gillian
Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, Australia.
Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.
Emerg Med Australas. 2025 Aug;37(4):e70088. doi: 10.1111/1742-6723.70088.
The traditional emergency department (ED) is not well suited to older people's urgent, but non-life-threatening, care needs. The Complex And Restorative CentrE (CARE) is a new service established in Adelaide (South Australia) designed to provide urgent care for older people and to reduce ED presentations for this population group. This study explores staff and referrer experiences of the service and identifies potential challenges for future sustainability and scale-up.
Semi-structured interviews with CARE staff and service referrers were conducted. Transcripts were analysed inductively using a thematic approach.
A total of 13 CARE staff members and five referrers took part. While the service was well perceived, in- and outbound referral processes, and its small size were identified as areas in need of addressing to support sustainability. Specifically, key considerations were 'streamlining referral and intake processes', 'care planning and optimising bed availability' and 'acute care access gaps'.
Our findings emphasise how quality improvement initiatives, informed by staff and patient feedback, can drive necessary adjustments to enhance service user and stakeholder satisfaction. Our study has provided insights that can help guide CARE and similar programmes in evolving to meet growing urgent care needs for older populations, improve patient outcomes, and support long-term viability in healthcare systems.
传统急诊科不太适合满足老年人紧急但不危及生命的护理需求。综合康复中心（CARE）是在阿德莱德（南澳大利亚）设立的一项新服务，旨在为老年人提供紧急护理，并减少该人群到急诊科就诊的次数。本研究探讨了工作人员和转诊者对该服务的体验，并确定了未来可持续发展和扩大规模的潜在挑战。
对CARE工作人员和服务转诊者进行了半结构化访谈。使用主题分析法对访谈记录进行归纳分析。
共有13名CARE工作人员和5名转诊者参与。尽管该服务得到了较好的认可，但内外转诊流程以及规模较小被确定为需要解决的领域，以支持其可持续发展。具体而言，关键考虑因素包括“简化转诊和接待流程”、“护理规划和优化床位可用性”以及“急性护理获取差距”。
我们的研究结果强调了如何根据工作人员和患者的反馈开展质量改进举措，推动必要的调整，以提高服务使用者和利益相关者的满意度。我们的研究提供了一些见解，有助于指导CARE及类似项目的发展，以满足老年人群不断增长的紧急护理需求，改善患者预后，并支持医疗系统的长期生存能力。
