A Multi-Stakeholder Qualitative Evaluation of ED PLUS: A Physiotherapy-Led Transition to Home Intervention for Older Adults Following Emergency Department Discharge

Introduction: Older adults frequently attend Emergency Departments (EDs) and experience high rates of adverse outcomes, including functional decline, re-presentation, and unplanned hospital admissions. Developing effective interventions to prevent these outcomes is a priority. Healthcare providers (HCPs) are well positioned to create integrated care pathways for older adults discharged from the ED. ED PLUS is a physiotherapy-led, multidisciplinary model that bridges the care transition between the ED and the community. It initiates a Comprehensive Geriatric Assessment (CGA) in the ED and provides multidisciplinary follow-up to the patient for six weeks post-discharge. Purpose: This study aimed to explore the views and experiences of older adults and HCPs involved in the ED PLUS intervention to inform the design of a future definitive trial. Methods: A descriptive qualitative design was used. Older adults (n = 9) and HCPs (n = 10) who participated in the intervention arm of the ED PLUS trial were invited to participate in semi-structured interviews exploring their experience and perspective of the ED PLUS intervention. These interviews were audio-recorded, transcribed, and analysed using reflexive thematic analysis. Results: Nine older adults and six HCPs consented to participate. The evaluation highlighted stakeholders’ experiences and suggested modifications for optimising ED PLUS. Four themes emerged: ● ED PLUS bridged the transition between care settings for older adults. ● Stakeholder collaboration and investment were key enablers of implementation. ● Organisational, logistical, and personnel issues impeded the intervention’s delivery. ● There is potential for service optimisation and expansion. Conclusion: This evaluation emphasises the important role of physiotherapists and other HCPs in transitional care delivery for older adults. The findings will inform future trials of the ED PLUS model, aiming to improve outcomes for this population.