Staff and Referrer Experiences and Challenges With a New Emergency Department Avoidance Service for Older People: A Qualitative Study

Objective: The traditional emergency department (ED) is not well suited to older people's urgent, but non-life-threatening, care needs. The Complex And Restorative CentrE (CARE) is a new service established in Adelaide (South Australia) designed to provide urgent care for older people and to reduce ED presentations for this population group. This study explores staff and referrer experiences of the service and identifies potential challenges for future sustainability and scale-up.

Methods: Semi-structured interviews with CARE staff and service referrers were conducted. Transcripts were analysed inductively using a thematic approach.

Results: A total of 13 CARE staff members and five referrers took part. While the service was well perceived, in- and outbound referral processes, and its small size were identified as areas in need of addressing to support sustainability. Specifically, key considerations were ‘streamlining referral and intake processes’, ‘care planning and optimising bed availability’ and ‘acute care access gaps’.

Conclusions: Our findings emphasise how quality improvement initiatives, informed by staff and patient feedback, can drive necessary adjustments to enhance service user and stakeholder satisfaction. Our study has provided insights that can help guide CARE and similar programmes in evolving to meet growing urgent care needs for older populations, improve patient outcomes, and support long-term viability in healthcare systems.