Dr Nicky Baker, Research Fellow, ARIIA

Over the last decade there has been a 32% increase in people aged 65 years and older in Australia. With the increase in ageing population, there has been an associated 5.9% increase in residential aged care admissions nationally, so that, today more than 200,000 Australians live in residential aged care (RAC)¹. Of all the states and territories, Tasmania has the highest proportion (20%) of the population aged 65 years and older, and of these, 36.5% live in residential aged care². People aged 65 years and older are more likely than younger age groups to be hospitalised, experience a longer length of stay (LOS), and have higher rate of readmission. Longer stays in hospital for older people leads to increased likelihood of hospital acquired conditions, cognitive and physical deconditioning, and functional decline³. Further, the financial and system cost of managing unnecessary or avoidable presentations creates additional burden to an already overstretched health system⁴. Residents in RAC homes are often frail with multiple comorbidities. The priority for medical management of these comorbidities is a regular maintenance control rather than cure⁵. However, this group can also be frequent users of emergency ambulance and hospital services. The ambulance travel and hospital admissions are stressful for residents and families, and are costly to the health system, yet are often avoidable⁶. 

The Aged Care Reform Unit (ACRU) of the Tasmania Health Service (THS) was launched in January 2023. They deliver programs to improve access and flow between RACs and hospitals for better resident outcomes and health system benefits. ACRU also facilitates the Tasmanian Aged Care Collaborative (TACC) whose overarching purpose is to support delivery of person-centred care for residents in their movement between RAC and hospitals.

'To call or not to call' for residential aged care nursing staff is a proof-of-concept initiative that involves face-to-face workshops, provision of evidence-based resources, and follow up support via peer support and mentoring to address these issues.  The collaboration is supported by THS’ ACRU, the Aged Care Quality and Safety Commission (ACQSC), Ambulance Tasmania, Primary Health Tasmania and Aged care Research and Industry Innovation Australia (ARIIA).

The aims of the evidence-based practice workshops to be held across Tasmania in the week of the 24 March 2025 are: to increase capacity of residential aged care ENs and RNs with early identification and response to deterioration in the older person; to engage the right clinical support in place; to strengthen clinical reasoning, decision making and communication skills; and to make direct referrals to supporting Tasmanian Health Services (THS). 

Evidence-based resources include the Aged Care Learning Information Solution (Alis) learning platform, the after-hours tool-kit for aged care, information on shared transfer of care. These will be used by workshop facilitators to support experiential learning through case studies developed by ACQSC on scenarios depicting an older person who has fallen, an older person experiencing clinical deterioration and multiple hospital presentations, and an older person requiring end-of-life care.

Evaluation of this collaboration and the initiative aims to provide the evidence to support other regional areas to address these national issues in a context- and state-specific way; to support the aged care workforce to provide care in place wherever possible; and to meet the preferences and needs of older people living in residential aged care.

1. Source: (Australian Government 2025) Aged Care Research and Reporting

2. Source: (Australian Institute of Health and Welfare 2024) AIHW

3. Palmer (2018) The Acute Care for Elders Unit Model of Care. Geriatrics

4. Chen et al. (2024) Preventing functional decline in hospitalized older adults in medical ward: a best practice implementation project  JBI

5. Hillen et al. (2017) Disease burden, comorbidity and geriatric syndromes in the Australian aged care population Australasian J Ageing

6. Gullick & Islam (2023) Exploring avoidable presentations from residential aged care facilities to the emergency department of a large regional Australian hospital Australian J Rural Health

*The views and opinions expressed in Knowledge Blogs are those of the authors and do not necessarily reflect those of ARIIA, Flinders University and/or the Australian Government Department of Health and Aged Care.

​Paul Ross, Librarian & Information Specialist, ARIIA
Dr Stephanie Champion, Research Fellow, ARIIA

Understanding what drives success in aged care is essential for implementing evidence-based improvements. The process of gathering information, evaluating its reliability, and determining its relevance to your specific needs can be complex and overwhelming! Where do you start? It requires a solid understanding of evidence-based practice and an understanding about how to put that into action. An evidence-based approach integrates the best available evidence, professional expertise, and knowledge of your specific care setting—whether residential or home-based—while also considering consumer perspectives and preferences. Fortunately for the sector, this is what ARIIA have expertise in, and our mandate is to build up these capabilities in the aged care workforce to drive practice change together.

The definition of "best" evidence may vary depending on what you are looking for and the type or quality of the available studies. While ‘systematic’ and ‘umbrella’ reviews are often regarded by researchers as the best sources, they may not always address your specific needs, contexts, or provide you with the practical information you’re looking for. In such cases, it becomes necessary to explore a wider range of sources and to learn the tricks to be able to critically assess the strengths and limitations of each source, to ensure you’re using evidence, that is fit for purpose.

Overall, the variables of evidence-based practice in aged care include:

• Define the Problem: Clearly describe the issue you aim to address. Consider any contextual or organisational factors that may impact your approach, such as environmental constraints, budget limitations, timelines, and securing support from leadership.
• Plan Your Approach: Identify and assess the quality of appropriate information sources, develop a plan for what change you are going to implement, and include methods to test its safety and effectiveness in addressing the original problem.
• Implement and Evaluate: Follow your plan and implement the change and collect data on progress and process along the way so that you can tell if you are making a difference. Be prepared to revisit and update your plans periodically to ensure ongoing relevance and success.

To effectively use evidence and drive change, you will need specific skills, access to reliable and up-to-date evidence sources, and an overall research and implementation plan. To support this process, ARIIA offers various programs and services designed to guide you through the complexities of identifying evidence-based solutions for your practice needs, seeking to save you time and give you access to some of the most relevant sources related to aged care in Australia.

The Knowledge and Implementation Hub (KIH) provides a vast amount of free online information and resources to support the process of evidence-based practice, these include:

• Our aged care priority topics scoping reviews and a searchable collection of supporting online resources.
• The aged care search collection provides predefined one-click PubMed searches in a variety of formats (free to access, review quality and studies focused on Australian). Alongside these we have designed tailored Google searches on our priority topics and developed additional research sources which complement our organisations and programs and older people and families pages. 
• We also provide access to the highest quality reviews via our systematic review collection in aged care, which is updated monthly consisting of both open access and subscription-based reviews. 
• Implementation training supports such as a short implementation learning module on the basics of implementation and three themed supports on Reablement, Nutrition and Workforce Retention.

Finally, ARIIA provides the Innovation Capability Program offering the aged care workforce training, support and guidance needed to change the way things are done and build up their transferable skills. The program helps to develop solutions grounded in evidence, to ensure meaningful, impactful and sustainable results. The program supports you to define your problem, provides information and guidance into searching and using evidence, while enabling you to consider implementation barriers and plan for project success. Applications for a new round of training are now open for more information contact the ICP team.

*The views and opinions expressed in Knowledge Blogs are those of the authors and do not necessarily reflect those of ARIIA, Flinders University and/or the Australian Government Department of Health and Aged Care.