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In rapidly aging settings such as Singapore, many ED visits are potentially preventable. EAGLEcareACT links emergency physicians with nursing home staff to triage residents and manage care needs within nursing homes, with preliminary evaluation suggesting fewer avoidable ED visits. A qualitative CFIR-guided pre-implementation study will interview nursing home managers, staff, ED physicians, and families, assessing current practices, care complexity, barriers and facilitators, and person-centered outcomes for a pragmatic trial.",{"@graph":69,"@context":126},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/reducing-ed-visits-optimizing-an-interdisciplinary-telemedicine-program-in-singapore-nursing-homes/426641/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/reducing-ed-visits-optimizing-an-interdisciplinary-telemedicine-program-in-singapore-nursing-homes/426641.png","ImageObject",300,407,{"name":92,"@type":93},"Muffet","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-22","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118,122],{"name":109,"@type":110,"acceptedAnswer":111},"Why target emergency department visits in Singapore nursing homes?","Question",{"text":112,"@type":113},"ED utilization among nursing home residents is reportedly high, and a study cited shows many visits lead to hospital admission. Preventable ED use is a concern in rapidly aging societies like Singapore.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What is the EAGLEcareACT telemedicine program?",{"text":117,"@type":113},"EAGLEcareACT connects ED physicians with nursing home staff to triage patients and address care needs within nursing homes, aiming to reduce avoidable ED visits.",{"name":119,"@type":110,"acceptedAnswer":120},"How will the pre-implementation study be conducted?",{"text":121,"@type":113},"The study will follow the Consolidated Framework for Implementation Research (CFIR) and use semi-structured qualitative interviews with nursing home managers, nursing home staff, ED physicians, and family members of residents.",{"name":123,"@type":110,"acceptedAnswer":124},"What will be analyzed to support implementation of EAGLEcareACT?",{"text":125,"@type":113},"Researchers will assess current practices and the complexity of residents’ care needs, identify perceived barriers and facilitators, and extract person-centered outcomes to measure in a pragmatic trial using NVivo 14 with deductive/inductive coding based on CFIR domains.","https://schema.org",{"og:url":83,"og:type":128,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":130,"canonical":83},"index,follow",{"doc_id":132,"site_id":62},426641,1790765296,{"code":4,"msg":5,"data":135},{"doc_id":132,"user_id":136,"nickname":92,"user_avatar":137,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":138,"file_id":139,"file_url":140,"file_type":141,"file_size":142,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":143,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":144,"faqs":145,"seo_title":146,"seo_description":67,"update_tm":147,"read_time":81},962090768927,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","370 Innovation in Aging, 2025, Vol. 9, No. S2  \nAbstract citation ID: igaf122.1255  \nREDUCING ED VISITS: OPTIMIZING AN  \nINTERDISCIPLINARY TELEMEDICINE PROGRAM IN  \nSINGAPORE NURSING HOMES  \nJiameng Yuan1, Gayathri Devi Nadarajan2, Marcus Ong3, Jean Mui Hua Lee4, and Hanzhang Xu1, 1. Duke University, Durham, North Carolina, United States, 2. Singapore General Hospital, Singapore, Singapore, 3. Duke-NUS Medical School, Singapore, Singapore, 4. Sengkang General Hospital, Singapore, Singapore  \nEmergency department (ED) utilization among nursing home (NH) residents is reportedly high, with one study showing 42.4% of visits leading to hospital admission. This could be particularly pronounced in rapidly aging societies like Singapore. Prior research has suggested that many ED visits from NHs residents were are often preventable. Our prior work has developed and pilot tested a telemedicine program (EAGLEcareACT [Enhancing Advance Care Planning, Geriatrics, and End-of-Life Care Acute Care Team]) that connected ED physicians with NH staff to triage patients from NHsand address care needs within NHs. Preliminary evaluation has suggested EAGLEcareACT reduces avoidable ED visits among older adults from NHs. To broadly implement EAGLEcareACT through a large-scale, pragmatic trial, we sort to conduct a qualitative pre-implementation study, guided by the Consolidated Framework for Implementation Research (CFIR). We plan to conduct semi-structured qualitative interviews with 2 NH managers, 4 NH staff, 2 ED physicians, and 4 family members of NH residents. We will comprehensively assess the current practice at each targeted NHand the complexity of care needs for NHs residents. We will explore perceived barriers and facilitators of this interdisciplinary telemedicine program and seek input on person-centered outcomes that should be measured in this pragmatic trial. All interviews will be recorded and transcribed verbatim, with fieldnotes supplementing the interview transcription. We will analyze data in Nvivo 14 using both deductive/inductive coding based on CFIR domains.This information would optimize the implementation and expansion of EAGLEcareACT as well as enhance its sustainability and effectiveness in NH settings.","cbCaiu4LNFRjxM14","https://ap.wps.com/l/cbCaiu4LNFRjxM14","pdf",370256,"English","# Background\n# Study Rationale and Prior Work\n# Planned CFIR-Guided Pre-Implementation Study\n## Participants and Data Collection\n## Assessment Plan and Outcomes\n## Analysis Approach\n# Expected Contribution","[{\"question\":\"Why target emergency department visits in Singapore nursing homes?\",\"answer\":\"ED utilization among nursing home residents is reportedly high, and a study cited shows many visits lead to hospital admission. Preventable ED use is a concern in rapidly aging societies like Singapore.\"},{\"question\":\"What is the EAGLEcareACT telemedicine program?\",\"answer\":\"EAGLEcareACT connects ED physicians with nursing home staff to triage patients and address care needs within nursing homes, aiming to reduce avoidable ED visits.\"},{\"question\":\"How will the pre-implementation study be conducted?\",\"answer\":\"The study will follow the Consolidated Framework for Implementation Research (CFIR) and use semi-structured qualitative interviews with nursing home managers, nursing home staff, ED physicians, and family members of residents.\"},{\"question\":\"What will be analyzed to support implementation of EAGLEcareACT?\",\"answer\":\"Researchers will assess current practices and the complexity of residents’ care needs, identify perceived barriers and facilitators, and extract person-centered outcomes to measure in a pragmatic trial using NVivo 14 with deductive/inductive coding based on CFIR domains.\"}]","Reducing ED Visits - Optimizing an Interdisciplinary Telemedicine Program in Singapore Nursing Homes | PDF",1790641263]