Return to emergency department

Percentage of designated supportive living (default) or long term care (click toggle to compare) residents that returned to the emergency department within 72 hours or 30 days of their initial or previous visit to the emergency department. (see data dictionary)

What do you think?

  • Looking at these results over time, are there differences between zones? Between designated supportive living and long term care? What factors could account for these differences?

Whether you’re a patient, provider, or health system administrator, thinking about why these differences might exist can start conversations and lead to solutions for improved quality of healthcare.

Data courtesy of Alberta Health Services and Alberta Health

Understanding “return to emergency department”  

Emergency department visits are typically infrequent and necessary only when there is a critical and time-sensitive healthcare need. When patients use the emergency department multiple times in close succession, it is important to understand why. Monitoring returns to the emergency department can help us to understand if residents in designated supportive living and long term care are getting the care they need at the right time and right location.

For example, a return to the emergency department within 72 hours might indicate the resident:

  • Was not ready to be discharged or released from the emergency department,
  • Has complex health needs and requires time-sensitive, specialized care (e.g., palliative or end of life care) that cannot be provided at the supportive living or long term care site, and/or
  • Experienced a new health-related issue that required immediate attention that could not be provided on-site.

A return to the emergency department within 30 days might indicate:

  • A continued or rapid change in the health status of a resident or
  • The resident’s complex health needs still require time-sensitive, specialized care (e.g., palliative or end of life care) that cannot be provided at the supportive living or long term care site.

This chart does not indicate if the resident returned to the emergency department for the same reason or a new reason.

Considerations when viewing the results:

When thinking about designated supportive living and long term care residents that return to the emergency department, providers and leaders can consider a number of things to better understand and improve these results. Some questions they could ask before taking action include:

  • What are the reasons residents return to the emergency department? What are the most responsible diagnoses for residents who visit the emergency department?
  • How might improved collaboration between acute care, emergency medical services, and continuing care operators improve appropriate use of the emergency department? How can we improve the quality of transitions for residents between a site and the emergency department to help prevent return visits to the emergency department?
  • How can sites be better prepared and supported to provide care or services to residents who are experiencing a rapid change in health status?

The Health Quality Council of Alberta uses the Alberta Quality Matrix for Health as a way of organizing information and thinking around the complexity of the healthcare system. This measure can be used as input to assess designated supportive living’s performance in these dimensions of quality:

LEARN MORE

Dimensions of Quality

  • Acceptability 
  • Accessibility 
  • Appropriateness 
  • Effectiveness 
  • Efficiency 
  • Safety