New Qld program upskills workers to reduce emergency admissions

Developed by Central Queensland University (CQU) and funded by the Queensland government, the Early Recognition and Response to Deterioration in the Older Adult (EDDIE) program is free, and teaches aged care workers additional skills and knowledge to assist them in reducing resident hospitalisations.

EDDIE was designed by mother-daughter duo Sam Matthews, a nurse on Bundaberg's Geriatric Emergency Department Intervention Team, and Joy Matthews, a nursing lecturer at CQU.

The Matthews developed the program to empower personal care workers in the sector to voice concerns about suspected deterioration of older adults.

"There's a lot of adverse side effects of coming to the emergency department if you're elderly or frail," Sam told the ABC.

"There's a lot of auditory and visual stimulus – it's a confusing, noisy place, and people get disoriented and try to get away or have falls and things like that."

Joy, the program leader, said the program would improve both workers' skill sets and outcomes for patients.

"Participants will gain in-depth and practical knowledge in the conditions that commonly lead to potentially preventable hospital [PPH] admissions," she said.

"Our goal in designing and delivering this program is to help upskill staff to add further value within aged care settings by recognising and escalating signs of deterioration, so that action can be taken before hospitalisation is required.

"Older people, especially those in aged care, are more likely to suffer from chronic conditions that lead to visits to [the] emergency ward and hospitals stays but by identifying signs of deterioration early, it is possible to discuss treatment options with residents and their families."

In 2020-21 Qld residents had 167,675 potentially preventable hospitalisations (PPH) – equating to 5.9 per cent of all hospitalisations.

The Australian Institute of Health and Welfare found 46 per cent of PPH were for people over 65.

Joy said simple things like urinary tract infections or constipation brought some PPH; however, "gaps" in communication between personal care workers and team leaders also often led to a trip to the hospital.

"Had we picked [those issues] up day one or two, we could have put treatment and care in place much earlier and avoided the hospital," she said.

"There's a gap between [personal care workers] spotting it and then being able to articulate it to their team leaders and escalate it."

Usually, facilities have their own policies and procedures to identify and escalate concerns.

However, Sam hopes the project will bring some uniformity across the sector.

"The course utilises an industry-approved tool that aims to streamline the process of escalating concerns and objectively reporting changes," she said.

"The hope is this will create a standardised approach within the aged care sector and improve communication with external agencies such as the Queensland Ambulance Service or primary healthcare professionals."

Shelton Murphy, a personal care worker at Anglicare, said his job included advocating for his residents, and the program helped him learn skills to identify issues and speak up.

"You are with them all the time, so you get to know the idiosyncrasies they have," Mr Murphy told the ABC.

"You pick up [changes] straight away … to be able to say, 'Look, Mary has got a problem, there's a significant change in her demeanour, she's been off her food for a couple of days, it seems to be a pattern'"

"And if you can get that across to the nurse, they can go from there."

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