The CEDRiC project aims to strengthen the capacity of the aged care sector to deliver high quality aged care, to improve care for older adults in the Emergency Department and improve interaction between the Residential Aged Care Facility (RACF) and both primary and secondary healthcare sectors.
The CEDRiC project was evaluated using the Donabedian (2003) Structure, Process and Outcomes framework. Structure and process evaluation was undertaken via qualitative interviews and descriptive analysis of staff activity. Outcome evaluation incorporated quasi-experimental methods comparing the intervention period with historical controls.
The primary outcome measure for HIPS was transfer of residents to the ED, with secondary outcomes including: disposition if transferred, length of stay in the ED or hospital if admitted, re-presentation within 28 days, mortality, number of consultations, type of consultation, and being seen by the GP or HIPS nurse prior to transfer. The primary outcome measure for GEDI was disposition with secondary outcomes including: ED length of stay, hospital length of stay and re-presentation within 28 days. An health economic analysis was completed to determine cost implications of the CEDRiC model.
Data collection and intervention time periods were:
- Pre-Intervention – HIPS Apr 2013 – Mar 2014; GEDI Jan 2012 - Dec 2012
- Developing (Interim) Intervention – GEDI Jan 2013 - Aug 2015
- Full Intervention – HIPS Jul 2015 – Jun 2016; GEDI Sept 2015 – Aug 2016
Results demonstrate that the CEDRiC interventions greatly improved outcomes for residents of the study RACFs and for older persons presenting to the ED across the Sunshine Coast, while saving costs for the Hospital and Health Service and assisting GPs to provide enhanced primary care. A toolkit has been produced to enable health professionals to replicate this model in practice. Publications related to the findings are currently under review.