SFH SYMPOSIUM NOVEMBER Affiliated with Affilié à
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1 THE OTTAWA HOSPITAL GERIATRIC PSYCHIATRY BEHAVIOURAL SUPPORT TEAM: PRACTICAL ASPECTS OF MANAGING BEHAVIORAL DISTURBANCE OF OLDER ADULTS ADMITTED TO ACUTE CARE SFH SYMPOSIUM NOVEMBER Affiliated with Affilié à
2 The Ottawa Hospital 1197 in-patient beds Geriatric Medicine Unit Geriatric Medicine Consult Team Geriatric Psychiatry Behavioural Support Team Geriatric Emergency Management Regional Geriatric Program of Eastern Ontario Geriatric Medicine Ambulatory Services & Day Hospital
3 DEMENTIA PATIENTS ADMITTED TO ACUTE CARE Increased use of the ED Increased admissions to hospital Complex clinical needs Difficult transitions Profound impact Poor outcomes
4 CURRENT STATE OF ACUTE HOSPITALS LOS 2-3 x longer with dementia Majority do not have diagnosis No consistent assessment of physical, mental health & social needs 94% of hospitals have no dementia care pathways High rate of anti-psychotic use Environments are not dementia patient friendly Staff lack dementia care training/education Ireland Audit 2014
5 CHALLENGE We need a hospital based solution.. Diagnosis Assessment & screening Care strategies Education Patient & family centred approach Organizational support
6 BEHAVIOURAL SUPPORTS ONTARIO Pillar 1: System Coordination & Management Pillar 2: Integrated Service Delivery - Intersectoral & Interdisciplinary Pillar 3: Knowledgeable Care Team & Capacity Building 6
7 THE OTTAWA HOSPITAL GERIATRIC PSYCHIATRY BEHAVIORAL SUPPORT TEAM 2013: Funding for the first acute care BSO team Goals: Reduced ED congestion & improved flow Reduced hospital admissions Reduced LOS in acute care Reduced ALC days Improved transitions Improved patient & family experience 7
8 OUR TEAM RN 2.4 FTE Geriatric Psychiatrist Advanced Practice Nurse 8
9 GPBST Target Population: Patients > age 65 Diagnosed or suspected history of age-related dementia Demonstrate challenging or responsive behaviours Focus: Assessment of behaviour/ triggers Implementation of both nonpharmacological & pharmacological strategies as appropriate Ongoing monitoring & support Supporting transition back to the community 9
10 PROCESS Review referrals & triage Daily rounds Assessment: Chart review: medications, medical history, labs & diagnostics Physical exam & MSE Identify red flags** Individualized care plan Follow-up Discharge planning Facilitate Discharge Assess Referral Develop Plan of Care Implement Reassess
11 Num of Cases Number of New Consults & Active Cases per Month Sept Mar New Consults Active Cases 11
12 Active Cases /Month Active Cases & Follow-ups per Consult Oct 2013 March Active Cases during Month (Avg) Follow-ups per 30 days* (Avg) Follow-ups per Consult to date* (Avg) 12
13 GPBST Successes: Stakeholder support Integration into continuum of care Improved communication Improved transitions Increased capacity re: behavioural management It (sic) helps support us through the stressful times & feel good about our management of difficult behaviours & medications provided 13
14 PATIENTS & FAMILIES Our family is so grateful for the level of care you were able to give to my father. We know this wasn t easy. Thank you & your team so much for caring enough to probe & uncover how we can best care for my Mom. We are very grateful! Your assessment of my Mom s condition & uncovering that she likely has Lewy Body Dementia as well, has helped our understand of the situation. It will help us better inform the other care providers involved in her care. Your nurses are incredible. 14
15 GPBST Opportunities: Efficient use of resources Focus on the ED Targeting: code whites, physical & chemical restraints, med assist etc. Integration & alignment with Geriatrics services Use of data reporting Improving clinical care: Pre-printing order set Education modules Patient & family experience 15
16 CHAMPLAIN BSO EXPANSION October 2016 Champlain LHIN directed funding for expansion of the Acute Care BSO Program Review & allocation of resources Orientation for new RNs Capacity building within acute care sector Accountabilities: Targets, evaluation & reporting Patient & Family Experience 16
17 CHAMPLAIN BSO EXPANSION Education: Orientation for new BSO RNs 19 educational events to 268 individuals across the LHIN GPA for acute care GPA Coach & Master Coach P.I.E.C.E.S. (2) DementiAbility Regional BSO Workshop Developed Regional & Provincial Performance Indicators Acute Care resource library for each site Integration of Patient & Family Experience Sustainability plan: Program planning & clinical support 17
18 SUMMARY Hospital based solution Clear process & accountability Organizational support for success Interdisciplinary approach that integrates assessment & management of both the mind & body Enhanced communication before, during & after admission Education strategy & sustainability plan are key Regionalization 18
19 QUESTIONS? Laura Wilding RN BScN MHS ENC(C) Advanced Practice Nurse Geriatrics Geriatric Medicine Consult Team Geriatric Psychiatry Behavioural Support Team Joint Appointment University of Ottawa School of Nursing 19
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