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Better access to home hospital for residents in Aged Care facilities


The project investigates ways to reduce hospitalisation rates for people in aged care facilities.

The research

Research suggests that residents from Residential Aged Care Facilities (RACFs) who are sent to hospital are more likely to experience stress, confusion, infections, falls, pressure injuries, delirium, medication errors and other complications.  Where treatment can be provided in the facility, survival rates are just as good, if not better than if treated in a hospital.  Satisfaction levels are also much higher for residents when remaining at the facility. 

This projects aims to:

  • Implement a model of care which assists residents of aged care facilities to increase the use of Home Hospital and reduce hospital admission and length of stay for those who are admitted;
  • Reduce costs associated with admission to tertiary cares settings;
  • Facilitate discussions (and documentation of these discussions) with residents and their families about ceilings of care/advance care planning. Development of a booklet to assist with and document advance care planning discussions.


  • There are many factors that impact on decisions on transfer to hospital from residential aged care facilities including staff knowledge of options, previous discussion and documentation of actions to be taken when health deteriorates, and practical issues relating to the accessibility of other options;
  • A highly valued new resource, called the Values & Wishes for Living Well and Healthcare Choices booklet was developed and found to assist with advance care planning discussions;
  • Systematic implementation of discussions about healthcare preferences is challenging and requires more research.


Targeted Research Fund, Department of Health WA


  • Professor Moira Sim (ECU and Silver Chain)
  • Associate Professor Glenn Arendts (Royal Perth Hospital, UWA and Silver Chain)
  • Dr Siva Krishnan (GP for Regis Hollywood; Baptistcare Gracehaven, Rockingham; Aegis Woodlake Aged Care)
  • Dr Teresa Fisher (GP for Royal Australian Air Force Association, Merriwa)
  • Associate Professor Roger Clarnette (Fremantle Hospital and ECU)
  • Associate Professor Trish Williams (ECU e-health informatics)

Project Officers

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