• admission avoidance;
  • advanced nursing practice;
  • emergency;
  • hospital in the nursing home;
  • nursing;
  • older people

crilly j., chaboyer w. & wallis m. (2012) A structure and process evaluation of an Australian hospital admission avoidance programme for aged care facility residents. Journal of Advanced Nursing 68(2), 322–334.


Aim.  To describe and evaluate the structures and processes involved in a hospital in the Nursing Home programme.

Background.  Older Australians are the largest consumers of healthcare, and as a result of the ageing process are at risk of developing hospital acquired iatrogenic complications. Hospital admission avoidance programmes that aim to provide care for patients in their own environment include Hospital in the Home and, more recently, Hospital in the Nursing Home.

Methods.  In 2006, a qualitative evaluation of a nurse-led Hospital in the Nursing Home programme using semi-structured interviews with 19 stakeholders was undertaken. Data analysis involved using start codes and content analysis.

Findings.  Effective referral and communication strategies were important for Hospital in the Nursing Home implementation. Furthermore, the Hospital in the Nursing Home programme manager had acute care and community experience and worked in an advanced practice role. These elements were integral to the programme’s operation.

Conclusion.  As the population ages, reducing hospital admissions for aged-care facility residents has the potential to improve patient outcomes. A structurally and procedurally sound programme is a key element in achieving this aim.