Healthcare Areas

Emergency department visits are typically infrequent and necessary only when there is a critical and time-sensitive healthcare need. When patients use the emergency department multiple times in close succession, it is important to understand why. Monitoring returns to the emergency department can help us to understand if residents in designated supportive living and long term care are getting the care they need at the right time and right location.

For example, a return to the emergency department within 72 hours might indicate the resident:

• Was not ready to be discharged or released from the emergency department,
• Has complex health needs and requires time-sensitive, specialized care (e.g., palliative or end of life care) that cannot be provided at the supportive living or long term care site, and/or
• Experienced a new health-related issue that required immediate attention that could not be provided on-site.

A return to the emergency department within 30 days might indicate:

• A continued or rapid change in the health status of a resident or
• The resident’s complex health needs still require time-sensitive, specialized care (e.g., palliative or end of life care) that cannot be provided at the supportive living or long term care site.

This chart does not indicate if the resident returned to the emergency department for the same reason or a new reason.

When thinking about designated supportive living and long term care residents that return to the emergency department, providers and leaders can consider a number of things to better understand and improve these results. Some questions they could ask before taking action include:

• What are the reasons residents return to the emergency department? What are the most responsible diagnoses for residents who visit the emergency department?
• How might improved collaboration between acute care, emergency medical services, and continuing care operators improve appropriate use of the emergency department? How can we improve the quality of transitions for residents between a site and the emergency department to help prevent return visits to the emergency department?
• How can sites be better prepared and supported to provide care or services to residents who are experiencing a rapid change in health status?

The Health Quality Council of Alberta uses the Alberta Quality Matrix for Health as a way of organizing information and thinking around the complexity of the healthcare system. This measure can be used as input to assess supported living’s performance in these dimensions of quality: Acceptability, Accessibility, Appropriateness, Effectiveness, Efficiency, and Safety.

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