Completion of key pieces of work within the STAAR-SA program (State Action On Avoidable Re-hospitalisations And Unplanned Admission: An Integrated Knowledge Translation Project Across SA) has highlighted areas of immediate action for improving care transitions for older people that Flinders University’s Caring Futures Institute is acting swiftly to remedy.
Two new projects that are building on the work that the STAAR-SA program identified are being led by Flinders University geriatrician Dr Craig Whitehead for SALHN (the Southern Adelaide Local Health Network), and by Flinders University’s Professor Maria Crotty (Professor of Rehabilitation and Aged Care) working as a rehab physician at SALHN.
“It has given us a stepping stone to the future work that needs to be done, to improve the current situation and avoid unnecessary hospitalisations for older people,” explains Professor Gillian Harvey, Matthew Flinders Fellow at the Flinders Caring Futures Institute and an instrumental researcher in the STAAR-SA program.
Acute problems that the STAAR-SA findings identified are clear: 22% of older South Australians (aged 65+) were hospitalised unexpectedly within 90 days of an ACAT (aged care eligibility) assessment. Hospital stays are short and readmission rates are high. Evidence-based strategies that improve older patients’ experiences and reduce hospital readmissions are not consistently applied.
“This is why there is an urgent need to improve the pathways of care for older people aged 65 years and over after discharge from hospital,” says Professor Harvey. “The new network that the STAAR-SA program has developed between clinicians, researchers and community members and service providers – in which Flinders’ CFI plays such a crucial role – will enable future work on preventing readmissions.”
Dr Whitehead is evaluating the hospital avoidance programs that SALHN has put in place, incorporating virtual care provision that will help divert unnecessary admissions of older people away from hospital emergency departments.
Professor Crotty’s state-wide project, supported by the Medical Research Future Fund, is implementing many of the new learnings identified by STARR across South Australia’s health and aged care networks. “The timing of this translation of research to clinical practice is critical,” says Professor Harvey. “This is such an important topic of interest in the community at the moment, so this work fits exactly with what the community deems to be a priority in health care.”
Improving out-of-hospital care for frail older people will ensure that the care provided is timely, coordinated, high quality and meets the needs and expectations that older people identified in the STAAR-SA research.
“There is still so much work to be done, but these projects are swiftly opening up new opportunities to connect with the people working in the health and aged care services, and to keep progressing the important work that has already been started with the STAAR-SA program.”
These programs are addressing an immediate need – one recognised and identified as vital in the wake of the Royal Commission into Aged Care Quality and Safety – and Professor Harvey says it’s important that Flinders’ CFI is being recognised as an essential asset that is already equipped and capable of taking immediate action.
“CFI is an interdisciplinary group, and we have both the academic expertise and the clinicians who already work in this space, plus close access to an even wider community of experts across Flinders University – and we need this very diverse group to overcome such a complex problem,” says Professor Harvey.
“There is no quick fix for delivering the right type of care at the right time for older people. It must be about ongoing work across the state with people all having the same aim – and that’s where the ongoing work of CFI is so valuable to our community.”