Shortening older in-patients’ stay by at least one day through direct geriatric unit admission using virtual emergency medicine tools

Abstract

Abstract Introduction Virtual emergency medicine (VEM) was introduced to improve ambulance and emergency-department flow through video calls with paramedics before hospital arrival. That way, acute geriatric patients may be referred from the Fiona Stanley Tertiary Hospital VEM service to the Rapid Assessment and Treatment Unit (RATU) at Fremantle Hospital, a specialised centre for geriatric care. The ambulance takes the patient directly to Fremantle Hospital instead of the Fiona Stanley Hospital ED. Aim and Method This retrospective observational study aimed to compare outcomes for older patients admitted to the RATU through the VEM–RATU and non-VEM pathways between January and June 2022. Results This study included 131 patients (64 VEM and 67 non-VEM). The groups were well matched in terms of comorbidities and demographics. However, the mean age of non-VEM patients (81.7 [7.3]) was lower than that of VEM patients (84.4 [8.0]) by 2.7 years (p < 0.05). On average, VEM patients underwent 2.0 fewer interdepartmental bed moves (1.0 [0.0]) than non-VEM patients (3.0 [0.2]; p < 0.0001). Inpatient length of stay (LoS) ≤ 80th percentile was generally ≥ 1 day shorter for VEM than for non-VEM patients (p < 0.001). The discharge destination (usual residence or nursing home) and the total number of hospital-acquired complications were similar between groups. Conclusions Our preliminary data show that patients admitted through the VEM–RATU pathway are slightly older than those admitted through the non-VEM pathway. In addition, the VEM–RATU pathway reduces bed moves and helps to reduce LoS up to the 80th percentile by ≥ 1 day. However, the VEM–RATU pathway does not appear to offer additional advantages in terms of discharge destination or reduced hospital-acquired complications. Further research is needed to clarify these preliminary observations.