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Grey Expectations A master class in improving elderly care

Grey Expectations A master class in improving elderly care. Jacqueline Thompson & Rebecca Blackwell. 2013. Introduction to the Geriatric Flying Squad Introduction to the Geriatric Emergency Department Your practice challenges. Aims. Background.

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Grey Expectations A master class in improving elderly care

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  1. Grey ExpectationsA master class in improving elderly care Jacqueline Thompson & Rebecca Blackwell. 2013

  2. Introduction to the Geriatric Flying Squad • Introduction to the Geriatric Emergency Department • Your practice challenges Aims

  3. Background Hospitals are bad places for old, frail people Sir David Nichols Jan 2013 Business as usual doesn’t work What new, innovative models of care for frail, elderly? What role do advanced nurse practitioners have in these innovations?

  4. Geriatric Flying Squad ….

  5. Award winning innovate service in Australia

  6. Open referral system Response time of 24 hours 1st assessment done with SW Weekly MDT Usually seen within a week by other AHP’s Direct admission to geriatric MAU, in-patient rehab Comprehensive geriatric assessment Paperless system Wireless technology Electronic access to surrounding hospitals GFS Domiciliary rapid response team

  7. Consultant Nurse (PT) Clinical Nurse Specialist (PT) Provided cover Mon – Fri, 8.00 – 4.30 2 social workers 1 OT/Physio 1 dietician Clinical psychologist Consultant Geriatrician Access to other AHP’s Who was in the team

  8. 166 patients kept living safely in the community annually 33% (52/166) avoided imminent presentation to ED 34 patients require a form of hospitalisation annually 88% (30/34) bypass ED using direct admissions Estimated 82 avoided ED presentations Therefore 82 avoided ambulance transfers Advantages

  9. Bringing a vision into reality….

  10. Geriatric Emergency Department – Mount Sinai Hospital, New York

  11. Mount Sinai Hospital in New York • Geriatric Emergency Department Innovations in Care through Workforce, Informatics, and Structural Enhancements (GEDI WISE) • Travel scholarship to develop nursing PhD • Aim: Investigate a new model of care and identify design principles that can be applied in the NHS Scholarship Background & Aim

  12. Data Collection & Unique Features

  13. Transferable Design Principles • Dissemination at home Trust • Influence in current research • On-going relationships with US practitioners Bringing it home: implementation & impact

  14. Further Dissemination

  15. Common challenging areas: • Whose priorities take precedent in interdisciplinary working? • How do you manage unmet and complex needs of older people? • How do you manage family dynamics during crisis? • When should planning start? Your concerns & challenges

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