Understanding how health professionals make transfer decisions with older people from hospital to residential aged care is important as it sheds light on a previously unexplored phenomenon as well as identifies the barriers and enablers in making these decisions. The literature review revealed a dearth of studies that focused on this particular aspect of transfer decision making in hospitals, which indicated that further research was needed to better understand this complex phenomenon. My study explored the lived experience of doctors, occupational therapists, physiotherapists, registered nurses and social workers in making transfer decisions with older people from hospital to residential aged care. The significance of my study is that it is the first that has examined health professionals’ transfer decision making from a phenomenological perspective. The application of a phenomenological approach informed by Husserl supported an understanding of health professionals’ experiences in making transfer decisions. This included the use of two data collection methods of interviews and observations to explore not only the descriptions of their lived experience in making transfer decisions but also in observing how they made these decisions. My study was conducted in five hospitals in New South Wales, Australia. The findings revealed that health professionals made transfer decisions by exploring options through assessments as well as collaborating with the older patient, family, carers, and the multidisciplinary team. However, this sometimes led to conflict. Overall, the health professionals gathered information and tried to make collaborative, safe transfer decisions, with limited options, under significant time pressures. The implications that arose from these findings for policy makers, hospital administrators and clinicians include the lack of transfer decision assessment tools and education on how to make these decisions along with the difficulties of accessing alternatives to transfer to residential aged care. The recommendations for future practice, research and education that arose from this research include strategies that support older patients’ choice as well as registered nurses’ participation in the transfer decision. Making quality transfer decisions requires both education and the development of comprehensive multidisciplinary transfer assessments which include access to supports
