Better Communication Needed Between LTC Facilities, Geriatric ERs

Critical patient information is not always properly communicated between long-term care (LTC) facilities and geriatric emergency departments (EDs).

In a session at the 2015 American Society of Consultant Pharmacists (ASCP) Annual Meeting and Exhibition in Las Vegas, Nevada, panelists explained that communication barriers between LTC facilities and geriatric EDs could ultimately lead to delays in care or excessive care.

“Sometimes, [elderly patients] are more sick than they’re able to communicate…and in the ED, we don’t know what their baseline is,” Stephanie Callinan, PharmD, CGP, of the US Department of Veterans Affairs, told session attendees.

Failing to properly communicate an older patient’s care history can also generate many unnecessary health care costs.

Medication errors cost $268 per patient, on average, and the increased length of stay associated with avoidable errors costs about $3244 per case.

However, clinical pharmacists included in team-based interventions can reduce the proportion of potentially inappropriate medications dispensed to elderly patients in the ED, the panelists said.

To investigate potential barriers to better communication between LTC facilities and geriatric EDs, researchers from the University of Maryland surveyed health care professionals working in LTC facilities.

The results demonstrated that patient information perceived as important, such as pertinent laboratory results and the name and contact information of the resident’s nurse, might not always be shared with the resident upon ED transfer.

Reasons for this information transfer discrepancy ranged from incomplete medical records to the resident requiring swift intensive care in the ED.

While researchers had specific recommendations for different health care providers, they identified 4 crucial roles that pharmacists can play to help narrow the communication gaps:

1. Prevent adverse drug events associated with ED admission.

2. Optimize medication regimen to prevent disease progression or exacerbation.

3. Perform medication reconciliation upon all transitions of care.

4. Facilitate communication with outside care providers to ensure quality of care for residents.

“Pharmacy services, as well as interdisciplinary care models, provide innovative services to improve quality of care for older adults in EDs,” the panelists concluded.