Improved outcomes for elderly patients: Everyone contributes!

Intensive Care (K1) won the AAPA 2017 Excellence Award for delirium screening.
Intensive Care (K1) won the AAPA 2017 Excellence Award for delirium screening.

The International Day of Older Persons takes place only once a year, on October 1, but seniors are recognized every day at the Jewish General Hospital through a program dedicated to promoting their safety and autonomy.

Nearly one in three hospitalized adults aged 75 and over experience a decline in function during their stay. This deterioration can have a serious impact on their life and well-being. An elderly person who was previously self-sufficient—who lived independently, in their own home—may now be at higher risk of placement in a long-term care facility. To help elderly patients maintain their autonomy and dignity, Specialized Approach to Senior Care (SASC, more commonly known by its French acronym, AAPA*) is practiced by staff throughout the hospital.

The program’s initiatives were on display as the multidisciplinary AAPA committee held the hospital’s first-ever AAPA Week at the beginning of October. Kiosks were set up in high-traffic hospital entrances to educate staff, patients and visitors on different strategies in senior-friendly care.

“The program sensitizes staff to the needs and perceptions of our elderly patients,” explains Geriatric Nurse Clinician Juliana Tebo. She cites as an example goggles on display at her AAPA Week booth, which simulate a degenerative eye condition common in the elderly. They are used during full-day training for PABs, to better understand how macular degeneration can affect a senior’s ability to carry out daily tasks such as going to the bathroom or feeding themselves. “It has been shown that we are more likely to do the right thing vis-à-vis our patient, to intervene appropriately, if we have a similar experience,” she says.

The program also examines every aspect of the hospital’s physical environment to ensure that it is safe and accessible to elderly patients, to better enable them to move about. This means creating and maintaining surroundings that are, for instance, free of clutter and well lit, that offer adapted toilets and clear and legible signage.

Practice AAPA, everyday

A key to the success of the program is the involvement of patients and their loves ones. “AAPA is an essential part of the everyday care that all staff provide, which includes teaching at the bedside,” says Ms. Tebo. “It is at the heart of every discussion and decision by the team, in concert with their patient and family members.”

Maxine Lithwick, a Co-Chair of the AAPA Committee, applauds the hospital’s multidisciplinary commitment to the program. “Everyone from physicians, nurses, PABs and allied-health professionals, along with housekeeping, kitchen and maintenance staff, work in partnership with patients and families to reduce the length of patients’ stay in hospital and prevent subsequent institutionalization,” she says.

Ms. Lithwick, who is also Coordinator of Social Services and Professional Practice for CIUSSS West-Central Montreal, notes, “All of these positive changes we’ve seen since the program was implemented at the JGH in 2013 have led to greater patient and staff satisfaction.”

Specialized training in AAPA practices is also available CIUSSS-wide. Staff may register through the nursing office at their site for such courses as Caring for the hospitalized older adult patient. To date, over 1,000 JGH healthcare workers and managers have received formal training in AAPA.

To learn more about AAPA, visit the CIUSSS intranet at Clinical Departments > Specialized Approach to Senior Care.

AAPA 2017 Excellence Awards winners

AAPA Week wrapped up with awards distributed to JGH teams and individuals for excellence in senior-friendly care.

Three awards recognized best performance by teams on AAPA quarterly audits.

Intensive Care (K1) won the AAPA 2017 Excellence Award for delirium screening.

The Cardiovascular Unit and Cardiovascular ICU (K2) won the AAPA 2017 Excellence Award for documentation and implementation of mobility plans.
The Cardiovascular Unit and Cardiovascular ICU (K2) won the AAPA 2017 Excellence Award for documentation and implementation of mobility plans.
Internal Medicine (K6) won the AAPA 2017 Excellence Award for documentation of geriatric vital signs.
Internal Medicine (K6) won the AAPA 2017 Excellence Award for documentation of geriatric vital signs.

 

 

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