Criticisms of the provision of end-of-life care in Residential Aged Care Facilities (RACFs) are widely documented. Novel sustainable service delivery models are required to ensure timely access to specialist palliative care (SPC) for this frail population, as well as support for staff in this care setting. This study reviews a transitional program, the Palliative Residential Aged Care Consult Service (PRACCS), that supported discharges from an inpatient setting into RACFs, with an aim to improve the quality and coordination of care, as well as reduce hospital readmission rates.  

 

To better support people with palliative care needs in the residential aged care setting via a consultative service delivery model.

A scoping review of the services providing palliative care to RACFs facilitated better care coordination. PCOC reports reflected the quality of care. A retrospective cohort design was used to investigate the impact of PRACCS on readmission rates to hospital within 7 days and 30 days for patients. The pre-PRACCS period covered Feb-Aug 2019 and was compared with the PRACCS intervention period Feb-Aug 2021. 

 

Results
Care coordination was improved between services providing care to RACFs. PCOC reports were better than other palliative care reporting PCOC data for RACFs in Victoria. Those who accessed PRACCS were less likely to be readmitted to hospital within 7 days (β=-0.13, p = 0.089) and 30 days (β=-0.21, p < 0.05).

 

These findings suggest the PRACCS model was effective at coordinating and delivering high-quality care in RACFs and at reducing readmission rates at 7 days and 30 days post-discharge from the hospital setting.