In-reach nursing services improve older patient outcomes and access to emergency care

<b>Aims</b><br>To identify the impact of in-reach services providing specialist nursing care on outcomes for older people presenting to the emergency department from residential aged care.<br><br><b>Methods</b><br>Retrospective cohort study compared clinical outcomes of 2278 presentations from 2009 with 2051 presentations from 2011 before and after the implementation of in-reach services.<br><br><b>Results</b><br>Median emergency department length of stay decreased by 24 minutes (7.0 vs 6.6 hours, P < 0.001) and admission rates decreased by 23% (68 vs 45%, P < 0.001). The proportion of people with repeat emergency department visits within six months decreased by 12% (27 vs 15%). The proportion of admitted patients who were discharged with an end of life palliative care plan increased by 13% (8 vs 21%, P = 0.007).<br><br><b>Conclusions</b><br>There was a significant reduction in the median length of stay, fewer hospital admissions and fewer repeat visits for people from residential aged care following implementation of in-reach services.