A HSE Mid West multi-agency pilot program for nursing home staff has helped reduce Emergency Department admissions from those homes by an average of 19%.
The triage project, a collaboration between the National Ambulance Service (NAS), HSE Mid West Older People Operations and nursing homes, was launched locally last Autumn.
Since its rollout in September 2024, the Nursing and Residential Triage(NaRT) tool has been introduced in 18 nursing homes across the Midwest, where staff have received dedicated training. Close, collaborative working relationships between NAS personnel and nursing home staff have been key to its success, along with increased awareness of NAS alternative care pathways. As a result, NAS teams have been able to manage a range of treatments within the nursing home setting, helping 56 patients avoid emergency admissions to University Hospital Limerick.
“With correct implementation, NaRT has a positive impact on emergency ambulance operations and Emergency Departments. It promotes more appropriate patient care and a better patient experience,” said Brian Creamer, Paramedic Tutor on the team.
“Triaging patients is the first step in avoiding admission to the hospital, and our personnel have worked with our colleagues in nursing homes to provide them with the guidance to develop their skills in making the best call to meet their patients’ needs.”
The NaRT initiative stems from concerns about deconditioning in older, frail people, which begins within hours of their lying on a hospital bed or trolley. Up to 65% of older patients experience a decline in function during hospitalisation, and a 2017 British Geriatrics Society study shows that many of these patients could prematurely end up in residential care due to deconditioning.
The initiative is also informed by CSO projections tracking a significant increase in Ireland’s population aged 80 years and older. By 2051, this age group is expected to rise to as many as 549,000, underscoring the importance of planning for healthcare, social services, and infrastructure to support the needs of an ageing society.