How a Tertiary Hospital Implement the Principles of Age .... Ming-Yueh CHOU.pdf · How a Tertiary...
Transcript of How a Tertiary Hospital Implement the Principles of Age .... Ming-Yueh CHOU.pdf · How a Tertiary...
How a Tertiary Hospital Implement the
Principles of Age-Friendly Health Care
Ming-Yueh Chou, MD
Geriatric Medicine Center, Kaohsiung Veterans General Hospital, Taiwan
Health care of older people in Taiwan
People aged 50 and over used
- 42.8% of outpatient visits
- 52.5% of hospitalizations
People aged 65 or over
- >95% used outpatient services
- Annual outpatient visit: 27 visits
National Health Insurance in 2007
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Taiwan’s Framework of
Age-friendly Hospital
the WHO age-friendly principles
the WHO HPH model
the Vancouver Island Health Authority’s Elder-Friendly
Hospital Initiative
It consists of vision, values, missions,
and strategies on four dimensions
- management and policy
- communication and services
- processes of care
- physical environment
Kaohsiung Veterans General Hospital
A tertiary medical center
1389 beds
Outpatient: 108,000 visits per month
65-y/o : 38.8%
ED: 7159 visits per month
65-y/o : 27.2%
Inpatient: 3375 per months
65-y/o : 42.6%
Established in 2004
Core Value:
- Integrated Services、Team Work、Respect Life
Mission:
– Provide Good Quality Care
for Older Persons
– Develop a Good Team Work
– Be an Excellent Training Center
for Geriatric Medicine
Geriatric Medicine Center
Taiwan’s Framework of
Age-friendly Hospital
Strategy 1: Management policy
1.1 Developing an age-friendly policy
1.2 Organizational support
1.3 Continuous monitoring and improvement
Promote Geriatric
Medicine
Value the care for older
persons
Build up Geriatric
Medicine Building
Drive policy of
geriatric medicine
Expend Geriatric
Medicine
Age-Friendly Environment
Our Management Policy
Taiwan’s Framework of
Age-friendly Hospital
Strategy 2:Communication and services
2.1 Communication
2.2 Services
All healthcare professionals,
hospital staff and volunteers
Continuing Education Programs
• More than 60 hours per year
• Including age-friendly principle, health promotion,
integrated services, gender, and so on.
• Should attend at least 2 hours per year
• Free for all healthcare staff outside our hospital
Continuing Education Programs
Doctors Nurses health care staff Volunteers
To empathy older people
Older Persons Simulation
Experience
Taiwan’s Framework of
Age-friendly Hospital
Strategy 3: Care processes
3.1 Patient assessment
3.2 Intervention and management
3.3 Community partnership and continuity of care
To solve the problems
of frequent ED visits
and unnecessary stay
To cooperate with ED
CGA in the ED
Project in the Emergency Department
Parking Area
Volunteers Reception for frail older persons
Special area for frail
passengers
Age-friendly Outpatient Service
Help to leave or go to cars
Convenient
administrative
processes Comfortable
Waiting Area
Readable signage
Integrated
Electric System
Age-friendly Outpatient Service
Fall
Clinics
(CGA)
Integrated Outpatient Services
Sheets for
Summary of All
Medications
Medication
consultation
Medication review
by IC cards
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Medication review
before admissions
Pharmaceutical Care
in the Older Persons
Drug boxes, Big Stickers
Pharmaceutical and Nutritional Care
Blood Drawing Area Radiological
Examinations
good lighting, non-slip floor surfaces,
stable furniture and clear walkways
Area for
Wheelchair
Age-friendly Examination Area
Walker Wheelchair hand railings
Award for the Best
Age-Friendly Environment, 2012
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Alarm System for Patients with
Dementia
Area 1
Area 2
Toilet
Alarm signal with music
Clock and Calendar Light Therapy
Good Lighting in daytime
Well Orientation to Avoid
Complications
Onsite Rehabilitation Area
Bladder
sonography
Accessible Toilet
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Hearing Aid
Glasses
Writing Board
Pictures
Reception of Nursing Station
Big Room Number
Devices for Communications
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Comprehensive Assessment for
Inpatients Nursing Assessment
基本資料
個人病史
日常生活
營養評估
身體評估
心理評估
環 境
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Multidisciplinary Team works
Records of MDT
meeting
MDT meeting every
week
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Doctors
Discharge Plan
Nurses
Discharge education
Intermediate Care for
disable patients
Discharge Plan and Intermediate Care
Community Services
Taiwan’s Framework of
Age-friendly Hospital
Strategy 4: Physical environment
4.1 the common principles of Universal Design
4.2 transportation
4.3 Simple and easily readable signage
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Common Principles of Universal Design
Project from Ministry of Health and Welfare, 2013
Help 15 hospitals to
provide integrated care for
older persons
• Age-Friendly Hospitals
• Integrated Outpatient
Services
• Team Care
Guidance for Integrated Care
Services for Older Persons
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Qualified as Age-Friendly Hospitals
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Thank You !