Transition from hospital to home - development of a settling service for the emergency department and the acute assessment unit

Aim: The availability of government funding to improve the care pathway for older people provided the opportunity to identify and address a current service need that would facilitate discharge and prevent avoidable admissions. Approach: A qualitative approach was used to identify gaps in services and barriers to quick and effective discharge with a project management model for service development, implementation and evaluation. Context: The service was developed by the Social Work Department, Sir Charles Gairdner Hospital (SCGH), specifically for patients discharged from the Emergency Department and the Acute Assessment Unit. Main Findings: The need was identified for a service aimed at early efficient discharge of the elderly with immediate transport and the provision of care. The 'Settling Service' was developed and implemented in close consultation with health professionals working in the Emergency Department, the Acute Assessment Unit and with other internal stakeholders. Positive feedback was received from patients, staff and internal stakeholders. Conclusion: The settling service was found to be to be cost-effective and to facilitate earlier discharges, thereby easing pressure on beds and reducing bed day costs. The settling service has continued on.