Visioning Session on Seniors and Geriatric Services

(Sample Presentation Slide Deck)

Date

Time

Venue

2

Session Outline

1. Welcome and Introductions

2. Where are we today?• Our LHIN • Our Hospital

3. Impetus for Change

4. Best Practices

5. Where do we want to be in 3 years?

6. Next Steps

3

Purpose of the Session

To create the hospital’s ‘vision’ for achieving excellence in services for seniors, including specialized geriatric services

4

Relevant Hospital Strategic Goals/Priorities

Where are we today?

• Our LHIN

• Our Hospital

6

Our LHIN’s IHSP Priorities

7

Status of Planning for Seniors in Our LHIN

8

Serving Seniors at our Hospital –Current State

• List current programs that specifically target seniors

• List any committees/task forces/working groups that are specifically focused on seniors issues

Impetus for Change

10

Seniors in Our LHIN

• Insert bar graph showing current and projected seniors population in the LHIN

• A stacked bar graph can be used to illustrate the different age cohorts within the seniors population (i.e. 65-74, 75-84, 85+)

11

Seniors account for 63% of all acute inpatient days and 43% of all provincial health expenditures in Ontario

12

Quality Concerns for Seniors in Acute Hospitals

• 2-fold risk for adverse events and surgical complications

• 50% of all nosocomial infection• 15-20% will develop hospital acquired delirium • Longer lengths of stay• High rates of re-admission• Loss of the capacity for independent living• More costly care (see next slide).

13

Ontario Case Costing Data, 2005/06

Comparison of Total Cost Per Case for Elderly Patients and All Patients

$9,269

$14,440

$8,437

$6,530

$7,768$7,464

$0

$2,000

$4,000

$6,000

$8,000

$10,000

$12,000

$14,000

$16,000

Fracture of Femur or Pelvis Pneumonia Severe Depressive Episode without PsychSymptoms

Av

era

ge

To

tal C

ost

Per

Case

Age 70+ All Patients

14

Ontario Case Costing Data, 2005/06

Comparison of Average Length of Stay for Elderly Patients and All Patients

13

24.5

11.5

7.1

14.5

9

0

5

10

15

20

25

30

Fracture of Femur or Pelvis Pneumonia Severe Depressive Episode without PsychSymptoms

Len

gth

of

Sta

y (

Day

s)

Age 70+ All Patients

Best Practices

16

Health Care Services for Seniors

Specialized Geriatric Services

17

What are Specialized Geriatric Services?

• Range of health care services, which diagnose, treat and rehabilitate frail elders with complex and multiple medical, functional and psychosocial problems

• Provided on a consultative basis by an interdisciplinary team of health professionals

• Provided in a variety of home, ambulatory, acute care, long-term care and rehabilitation hospital settings

• Aimed at reducing the burden of disability by detecting and treating reversible conditions and recommending optimal management of chronic conditions.

18

Benefits of Specialized Geriatric Services

• Decreased acute readmissions• Reduced rate of emergency department

admission• Decreased length of stay • Improved survival • Improved functional status

19

Best Practices in Specialized Geriatric Services

• Outreach• Outpatient Geriatric Clinics• Geriatric Day Hospitals• Acute Geriatric Units• Geriatric Rehabilitation Units (GRU)• Geriatric Assessment And Treatment Units (GATU)• Internal Consultation Teams• Psychogeriatric Services• Geriatric Emergency Management.

20

Best Practices in Senior Friendly Hospitals

• Processes of Care• Emotional and Behavioural Environment• Ethics in Clinical Care and Research• Organizational Support• Physical Environment

Where do we want to be in 3 years?

22

Small Group Discussion (15 minutes)

Group #1: Hospital Role

What should role should we play in seniors and geriatric services in our LHIN? What should we offer?

Examples of strategic choices:

Please pick someone to provide a 5 minute synopsis of your discussion

Narrow Scope Broad Scope

Generalists Centre of Excellence

Status Quo Transformational Change

Contributor/Partner Leader

23

Small Group Discussion (15 minutes)

Group #2: Organizational Fit

How can services for seniors and the geriatric population best be organized relative to other programs at our hospital?

Examples of strategic choices:

Please pick someone to provide a 5 minute synopsis of your discussion

Separate Integrated

Ad hoc Coordinated

24

Small Group Reports

25

This is where you are today

This is where you are going

• Program Design• Implementation

Plan• Organizational

Change

People - Staff

People -Leadership

Organization

Structure

Organizational Culture

Technology Facilities Processes

26

Organizational Capacity Needs Barriers

People

• Staff

• Leadership

Organizational Structure

Organizational Culture

Technology

Facilities

Processes

Next Steps

28

Next Steps – Developing the Business Case

Distribute Scorecard Questionnaire:

• What are the most important criteria for a successful business case for moving forward with our vision for seniors and geriatric services?

29

Next Steps – Timelines for Deliverables

Deliverables Estimated Timeline for Completion

Organizational Assessment Report

Program Design Report

Business Case