Home care referral after emergency department discharge

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The purpose of this study was to assess the need for home health care referral screening for elderly patients after ED discharge.The specific research question addressed was: Is there a need for home care referral screenings for elderly patients discharged from the emergency department?


A nonexperimental, retrospective, descriptive design was used in this project.


A convenience sample of 194 closed medical records was obtained from a Midwestern hospital emergency department.The medical records were from patients 65 years of age and older who had visited the emergency department during a 3-month period. One chart audit tool was completed for each medical record.


Eighty-eight (45.4%) of the 194 patients in the study could have benefited from a home care referral.


Elderly patients frequently access the health care delivery system through the emergency department, but little is known about the outcomes of such usage, particularly in the context of continuity of care.If home care referral screenings of elderly ED patients are performed and appropriate referrals are made before ED discharge, a seamless delivery system of health care is provided. A home care visit resulting from a referral may be all that is needed for the maintenance of a patient's condition. To improve the quality and continuity of patient care, home care screening should be integrated into the routine discharge ED activities. (J Emerg Nurs 1998;24:127-32)

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