A Geriatrician and Geriatric specialty nurse led consult service carried out in the Emergency Department for acutely ill Resident Aged Care Facility Residents (RACF), operated by the Geriatric Flying Squad (GFS) at The Sutherland Hospital (TSH) with two goals.

1.Reduce ED presentations
2.Decrease number of admissions for those who did present to TSH ED


The Sutherland Shire consists of 24 RACFs accommodating a total of 2560 residents who are serviced by the GFS at TSH. The role of the GFS has been to manage acutely ill residents within the RACF. There was always a recognized need for GFS consults in TSH ED to help facilitate discharges back to RACF and provide an alternative pathway of care for RACF residents.

A funding enhancement in Aged Care services at TSH in 2024 resulted in recruiting an additional 2.88 FTE (additional 6 staff) in the GFS team. An ED GFS pathway was formulated as a result. The GFS service was promoted via GFS posters, education and presentations at meetings. On June 3rd, 2024, the GFS ED pathway was implemented in TSH ED. The RACF resident consults were carried out during the morning handover round with the ED clinicians. During these handovers, patients suitable for discharge back to RACF were identified and plans made to facilitate seamless discharges. RACF residents who may not have been suitable for discharge were also identified and admissions recommended.

Results:

Results for the periods June - August 2023 compared to June - August 2024

There was an overall 42% reduction in presentations to ED during June - August 2024 compared to June - August 2023. In June 2024 there was a 42% reduction, July 2024, there was a 44% and in August 2024, there was a 40% reduction in admissions as a result of the ED-GFS pathway.