Abstract

Introduction

We implemented an acute hospital-nursing home collaborative pilot in two nursing homes with an objective to reduce emergency department visit and inpatient hospitalisation among nursing home residents. We aim to study the experiences of the healthcare staffs from the two nursing homes.

Method

Focus group discussions using semi structured interview guide were conducted on 26 nursing home staffs who have had experience in using the collaboration intervention. Transcripts were analysed using qualitative interview analysis.

Results

Five main domains were explored: knowledge and understanding; service satisfaction; challenges; enablers; and service improvements. Most of the ground staffs had incomplete grasp of the purpose and logic of the collaboration. However, the consensus obtained were that they felt reassured knowing they could consult hospital providers easily without activating emergency services immediately. Nursing home staffs also acknowledged having equipped themselves with skills to identify residents who required escalation of care. Interventions used such as NEWS assessment tool, hospital transfer forms and teleconsultation portal were found to be easy to use. Among the challenges faced on the ground were pressure by next-of-kins, nursing staffs’ lack of confidence, additional tasks of filling up pre-conveyance information. One of the key enablers is the motivation of staffs to improve patient care at nursing home. Increasing staffing, continuous training, and skills training were among aspects suggested for collaboration improvement.

Conclusion

Healthcare providers in nursing home faced adaptation issues during the initial pilot of the collaboration; nevertheless, they were in agreement that the collaboration is helpful for better patient care.

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