Abstract

Guidance from the National Institute for Health and Care Excellence in the UK was introduced in 2015 to improve the quality of the care pathway of transfers of care home residents to hospital when needed. The Red Bag scheme was developed by Sutton Clinical Commissioning Group in 2016 as a means of improving communication between organisations involved in the process by ensuring residents’ notes and other personal belongings were easily identifiable and kept in one place. The Red Bag was implemented in the North East of England in 2018. The aim of this study was to understand the knowledge of and experiences of front line ambulance staff who had potential to be involved with the transfer of care home residents to hospital. A mixed methods approach was used for the study. Participants were recruited by two research paramedics working in the North East ambulance service and approached to take part in a confidential, on-line survey using Survey Monkey®. Data was analysed through descriptive statistics and a constant comparative analytic framework to develop into concepts found in the free text comments, which were constructed into themes. Two hundred and fifty eight participants were recruited to the study. Six themes were identified in the data that represented the knowledge and experiences of the participants. Findings showed there was variance in the implementation, interpretation and use of the Red Bag in practice. Where effective communication took place, handovers worked well, however perceived organisational processes and avoidable delays prevented the optimal transfer of care. Improved communication between organisations is recommended, along with building capacity and capability within and between professional disciplines working at the front line of patient care were identified as fundamental mechanisms of streamlining handover processes for the vulnerable and older adults who live in residential care settings.