eldercare: planning your geriatric future
TRANSCRIPT
Eldercare: Planning your Geriatric Future
For the Rotary Club of North Scarborough July 11 2012Presented by: Tabatha Bowers RN (EC) MN GNC(c) CMSN (C),
Nurse Practitioner Geriatrics
The Scarborough Hospital• Who we are:
– Two general hospital campuses and seven community based sites– 3,700 staff, more than 700 physicians and
800 volunteers– A diverse range of services across eight
patient care areas:• Cardio-Respiratory & Critical Care• Medicine & Specialized Geriatrics• Emergency & Urgent Care• Family Medicine & Community Services• Maternal Newborn & Pediatrics• Mental Health• Nephrology & Dialysis• Surgery, Orthopedics & Rehabilitation
The Scarborough Hospital
Some key figures (2010/2011 fiscal year)
General Birchmount Total
Beds 324 226 550
Emergency Visits 59,029 44,831103,860
Admissions 18,042 13,187 31,229
Births 2,683 2,204 4,887
Square footage 574,388 435,000 1,009,388
Geriatric Emergency Management Work with ED team and patient/family to try to maximize
independence, and maintain living at home for as long as possible. Geriatric Emergency Management (GEM) Nurse provides a
comprehensive, focused nursing assessment for frail, elderly clients that present to the Emergency Department.
Emergency department visits are often sentinel events for seniors, threatening loss of independence, health and well-being. Through provision of a GEM nurse assessment, decline and loss of independence can often be prevented or postponed.
Available at both campuses Monday to Friday from 0800-1600 hrs. Saw over 400 patients last year
GAIN Geriatric Clinic Geriatric Assessment and Intervention Network (GAIN) Geriatric clinic
opened in January 2011 Proactively delivers specialized geriatric care to frail seniors, allowing them
to stay in the community and avoid unnecessary visits to the ER Interprofessional clinic that is led by nurse practitioners and consists of
geriatricians, gero-psychiatrist, physiotherapy, occupational therapy, social work, pharmacist and CCAC
Goals are to improve outcomes for frail seniors and provide linkages to community resources
Since opening, we have seen over 932 seniors for a comprehensive initial assessment and have had 611 follow up visits
Based on current patient satisfaction surveys, 100% of patients who come to the clinic would recommend it to family and friends who may need similar services (33% response rate)
Acute Care for the Elderly Acute Care for the Elderly (ACE) units are available at both sites inpatient acute care program Our team works with these patients, enhancing and maintaining their
functional and cognitive capacity, so they are well enough to return to the community
Our goal is to ensure the wellness of our elderly patients helps to minimize the need to transfer patients to long term care facilities
Medical supervision works closely with the team, including nursing, physiotherapy, occupational therapy, social work, pharmacy, nutrition, and speech language pathology as required.
Our team works closely with each patient every day to discuss the benefits of meeting his/her goals and any challenges that may affect discharge planning.
• General campus - 416-431-8200 ext. 3180• Birchmount campus - 416-594-2574
Alternative Level of Care (ALC) Programme We developed our ALC programme to provide better outcomes
for our Alternate Level of Care (ALC) patients at The Scarborough Hospital
These patients are currently being co-horted on a medical unit, with the goal to maintain or enhance their mobility, functional ability and support cognition
This is done through an abilities focus of care and our VALUE programme which provides recreational therapy activities such as Pet Therapy, Bingo, one-to-one visiting with our specially trained volunteers
There are 2 family practice physicians and 1 geriatric nurse practitioner working in partnership to manage the medical care of these patients
NPSTAT Nurse Practitioners Supporting Teams Averting Transfers
(NPSTAT) is partnered with 14 long term care homes in Scarborough.
Their goal is to decrease the rate of transfer to local hospital emergency departments by addressing acute and episodic illness in LTC residents through nurse practitioner assessment, diagnosis and therapy.
They are available Monday to Friday 0800-1600 hrs and on-call
We currently have 2 nurse practitioners in this role To date they have seen 3041 with only 46 resulting in transfer
to ER
Senior Friendly Hospitals We are currently working with both the CELHIN and the Regional Geriatric
Programme of Toronto to work towards becoming a senior friendly hospital
The hospital is responsive to developmental issues of seniors: circumstances, abilities and needs of older individuals and their families arising from normal consequences of the aging process
Assimilation of gerontological principles, approaches and considerations into care delivery by taking into account normal aging changes, critical elements of clinical knowledge, patient-focused philosophy of care with corresponding team processes
We are doing this by reviewing our policies and accessibility throughout the hospital in order to improve the patient experience
Why be Senior Friendly? Ensures seniors have the opportunity to function at their
maximum level of independence at all times Physical environments designed to accommodate
physiological changes of aging can significantly reduce disability in the elderly experienced while in hospital
Functional impairments that are slow to improve by discharge increases risk of admission to long-term care facilities
Complications such as falls, adverse drug reactions that can increase morbidity and mortality can be prevented
Recognizes, promotes and enhances patients’ abilities to meet their own needs, solve their own problems and mobilize necessary resources to feel in control of their lives
Next Steps….
To continue to build partnerships with our community partners in order to better serve our patients
To further build our VALUE programmeTo work towards achieving a Senior Friendly
Hospital designation
Thank you!