"Elderly patient discharged from ED at an inappropriate time"

About: Fiona Stanley Hospital / Emergency Department

(as a relative),

I just wish to voice my concerns at the recent care for my parent who was admitted to your hospital's Emergency Department from their nursing home. My parent was transferred to the hospital late at night recently for investigation of their swollen leg. My parent was then transferred back to the nursing home from your Emergency Department the following morning at 6am. I feel this was highly inappropriate to discharge an elderly person with dementia at this time of the morning. I am also highly annoyed that neither my sibling or myself were informed of my parent's admission. My parent then had to be taken back to Fiona Stanley the next day to have an ultrasound done to determine what was wrong. They then discovered a blood clot in my parent's leg. Whilst I can understand hospitals are busy, as my child is a nurse, surely they could have found a space for an elderly person even with the 4-hour turn around time in emergency! This is not the first time my parent has returned to their nursing home after a hospital trip to Fiona Stanley Hospital at an extremely ungodly hour in the morning. The other such time was approximately 6 months ago.

Responses

Response from Janet Zagari, Executive Director Transformation, South Metropolitan Health Service, South Metropolitan Health Service

picture of Janet Zagari

Dear sunhk73,

Thank you for taking the time to share your story and I am sorry to hear that the care we provided your parent did not meet your expectations.

I understand why you may feel upset that your parent was transferred back to the nursing home in the early hours of the morning and then needed to return for further tests later that day. I wanted to share with you that there are a number of factors staff in the ED take into consideration when determining the best plan for an elderly patient who has completed their care in the night or in the early hours of the morning. Staff assess whether they can be safely discharged home or not; if patients live at home by themselves, we will usually admit them until later in the morning. For patients who live in a nursing home or who have a family member with them and who staff are confident can be safely returned, we discharge as soon as their clinical treatment is finished. This is because ED is not a restful environment and patients, particularly those with dementia, can find the unfamiliar surroundings unsettling and distressing. We are sorry if this was not explained clearly.

When patients are transferred to the ED from a nursing home, we expect that the nursing home will let the family know. If the patient needs to be admitted to the hospital then hospital staff will ring the next of kin to make sure that they are aware. We hear that you would have liked to be called by the hospital and we are going to consider whether we should change our process to make sure we talk to families ourselves.

Kind regards

Janet Zagari

A/Executive Director Fiona Stanley Fremantle Hospital Group

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