Appropriateness of unscheduled hospital admissions from care homes

Harrison, J. K. , McKay, I. K., Grant, P., Hannah, J. and Quinn, T. J. (2016) Appropriateness of unscheduled hospital admissions from care homes. Clinical Medicine, 16(2), pp. 103-108. (doi: 10.7861/clinmedicine.16-2-103) (PMID:27037376)

Abstract

Unscheduled hospital admissions from care homes are common and potentially avoidable but little guidance is available as to what constitutes an appropriate hospital admission. We surveyed healthcare professionals’ opinions on a range of common scenarios affecting care-home residents. We developed seven clinical vignettes and an accompanying questionnaire. We used purposive sampling to obtain opinions from relevant primary care and secondary care teams. We asked assessors to comment on whether they would favour hospital admission and to justify their response using pre-selected options and/or free text. Admission to hospital was judged inappropriate in 54.6% of responses. Opinion on admission varied according to the case, with fewer than half of respondents agreeing for three of the seven cases. Recurring themes were uncertainty around services available to care homes and anticipatory care planning. The lack of consensus suggests that concepts surrounding inappropriate care-home admission are not shared by staff who provide care for this patient group.

• Item Type: Articles
• Additional Information: TJQ is supported by a joint Stroke Association/Chief Scientist Office Senior Clinical Lectureship. JKH is supported by a clinical research fellowship from Alzheimer Scotland and the University of Edinburgh Centre for Cognitive Ageing and Cognitive Epidemiology, part of the cross council Lifelong Health and Wellbeing Initiative (MR/L501530/1). Funding from the Biotechnology and Biological Sciences Research Council and Medical Research Council is gratefully acknowledged.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Grant, Dr Patrick and Quinn, Professor Terry and Burton, Dr Jenni
• Authors: Harrison, J. K., McKay, I. K., Grant, P., Hannah, J., and Quinn, T. J.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Clinical Medicine
• Publisher: Royal College of Physicians
• ISSN: 1470-2118
• ISSN (Online): 1473-4893
• Copyright Holders: Copyright © 2016 Royal College of Physicians
• First Published: First published in Clinical Medicine 16(2):103-108
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher