Blacktown Hospital team combating bed-block

The Aged Services Emergency Team (ASET) at Blacktown Hospital has won the Team of the Year award at the Western Sydney Local Health District Nursing and Midwifery Awards for 2026.  

The team have introduced groundbreaking initiatives improving patient care for older people coming to Blacktown Hospital, which has already saved the hospital the equivalent of 1,118 bed days.  

The small team comprises of four nursing staff; Bincy Abraham, Irene Berko, Lailandra Chandra, Sajani Shakya and social worker; Zeljko Torbica.

The role of ASET is to ensure patients over the age of 70 have a safe and suitable home to return to after their time in hospital.  

As the community of Blacktown continues to grow, the team noticed the rapid rise of elderly admissions turning into long hospital stays well after the patient was fit for discharge.  

Often referred to as hospital ‘bed block”, where a patient no longer requires acute medical interventions but cannot be discharged without a safe or appropriate home to return to.  

“We are seeing an increasing number of elderly patients coming to ED who then need to ask for nursing home placement. It wasn't the case before,” Bincy said.  

The team said the cultural and linguistic diversity of the Blacktown community, and complexity of the Aged Care system, meant people needed more support to help them seek a placement in an aged care facility.

Last year, the team proposed an adjustment to when and how these interactions take place, to try and improve the process for older patients.  

The pilot program involves starting the conversation about care needs when the person arrives in the emergency department (ED) and it’s already had a huge impact for patients and families.  

“If you start the dialogue in ED, you can focus on getting them medically cleared and set to go home, as long as there is somebody to look after them at home and services in place,” Sajani said.

“Connecting with these patients at the point of hospital presentation allows the team to assess what care may be needed following discharge and how that can be given.”  

While some people are looking to be placed in a residential aged care facility, others prefer, and are able, to receive hospital care at home through home visits by the team.  

“We are compassionate with our patients, and we empathise with family – it’s a shared decision-making process,” Irene said.  

Nurse Bincy says that sometimes it’s clear from a patient’s admission they won’t be able to return home, which is the best time to help them start looking ahead to what life will be like after hospital.  

“We try to do [aged care] placement from ED, if they've got everything ready… but if they don't have things in place, then they'll have to be admitted if they're not safe to go home while an application is made,” Bincy said.  

This initiative was called ASET-ED2Care and the 12-month pilot had stunning results, revolutionising aged-care transitions and more than halving the average length of hospital stay.

During the pilot of 43 patients, 91 per cent were discharged within 10 days, saving up to 1,118 bed-days.

Another project aimed at following up older patients who prematurely left ED also had immediate results, reducing re-presentations from 41% to 20% through proactive follow-up about home or aged care needs.  

These initiatives are the outcome of collaboration from a range of stakeholders within the hospital and the community, and Lailandra credits the success to the teamwork and collaboration across the district.  

“We have involvement from emergency staff specialists, doctors, nurses, social workers and the ED allied health team, and our community aged care geriatricians who do home visit with us. Plus, we have greater cooperation with aged care facilities,” Lailandra said.

The ASET team won the Blacktown and Mount Druitt Hospital’s 2026 team award before taking out the District-wide award in May.  

“We are here to help, and it's the togetherness to help a person in their moment of need, that makes a difference,” Bincy said.