Making Transitions From Nursing Home to Hospital Safer During COVID-19 Outbreak

In addition to being a research scientist in the Indiana Center for Aging Research at Regenstrief Institute, Kathleen Unroe, MD, MHA, is an associate professor of medicine at Indiana University School of Medicine and a practicing geriatrician. Courtesy of Regenstrief Institute

The COVID-19 pandemic has severely impacted nursing home residents, and many have been hospitalized. To help nursing homes and emergency departments (EDs) handle these difficult patient transfers, Regenstrief Institute research scientist and Indiana University School of Medicine associate professor Kathleen T. Unroe, MD, MHA, and colleagues have developed the top 10 points for safe care transitions between nursing home and emergency departments during the pandemic.

Acknowledging that issues, including scarce resources and the vulnerability of the nursing home population are universal, the authors write that evolving solutions are necessarily local. They produced this manuscript, they write, to guide conversation and planning between nursing homes and hospitals and to raise general awareness of the need to make transfers from nursing homes to hospitals safer.

The paper also emphasizes the need for nursing homes to work with residents and their families on advance care planning to determine whether or not hospitalization is desired.

"Especially during this pandemic, clarity on resident and family goals for care is critical," said Dr. Unroe. "Nursing home residents are at significant risk of having a poor outcome if they become sick from COVID-19. Clear communication around preferences for treatment and setting expectations has never been more important.

"For us to provide the best care for our seniors," Unroe said, "we must communicate across facilities and disciplines. Nursing home and ED providers need to directly and clearly hand-off care of patients transitioning across settings."

"COVID-19 in Older Adults: Transfers Between Nursing Homes and Hospitals" is published online in the Journal of Geriatric Emergency Medicine. In addition to Dr. Unroe, authors on the paper include Stacie Levine, M.D., of University of Chicago Medical Center; Alice Bonner PhD, R.N., FAAN, of the Institute for Healthcare Improvement; Adam Perry, M.D., of Geriatric Emergency Department Collaborative; and Donald Melady, MSc Ed, M.D. of University of Toronto.

Source: Regenstrief Institute

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