Background: There is no evidence-based guidance on the best care setting for older adults with hip fractures in residential aged care (RAC), however the RAC structure offers an opportunity for a systematic multidisciplinary approach. Since 2022, the Community Health in a Virtual Environment (CoHIVE), a geriatrician-led virtual service, has been integrated into the local health services to enhance care for this cohort.
Methods: This prospective qualitative study took place between 1/5/22 and 30/4/23 in an Australian metropolitan region. An electronic questionnaire, developed with stakeholder input, covered pre-discharge planning, the discharge process, and post-discharge coping. We reported the percentage favourable agreement between next-of-kin and RAC staff.
Results: Paired data from next-of-kin and RAC staff were available for 47 patients. At baseline, 87% had dementia. In pre-discharge planning, 29/47(62%) pairs agreed hospital decisions were communicated clearly. 38/47(81%) pairs felt that the process of leaving hospital was smooth. Post-discharge, 22/47(47%) pairs reported pain was well-managed, and 25/47(53%) pairs noted opportunities to mobilise within a week. At service completion, 37/47(79%) pairs agreed care needs were met in the RAC. 30-day readmission rate was 11%. 30-day and 12-month mortality rates were 9% and 34% respectively.
Conclusion: Despite a high prevalence of dementia, readmission and mortality outcomes were comparable to other studies. However the low agreement between next-of-kin and RAC staff suggests persistent gaps in health knowledge and communication, highlighting opportunities to enhance CoHIVE’s outreach bundle of care, aiming to improve patient and next-of-kin satisfaction, functional outcomes and coordination with RAC staff.