Authors (including presenting author) :
KWAN WS(1), LAU LW(1), CHENG PPP(2), MO KK(3), WONG WM(3)
Affiliation :
(1) Community Nursing Service, (2) Central Nursing Division, (3) Department of Medicine, Yan Chai Hospital
Introduction :
Yan Chai Hospital (YCH) Community Geriatric Assessment Team (CGAT) was established to take over the support to RCHEs in Tsuen Wan since 2007. After an Extension Project in 2009, the coverage was increased from 18 (56%) to 36 (92%) of RCHEs with the total from 1,955 to 3,809 residents. For empowerment, each RCHE was arranged a community nurse to be their primary nurse for providing administrative and additional clinical management support.
Objectives :
(1) Reduce the hospital service utilization (e.g. A&E Attendance, Emergency Admission, Hospital Bed-days) by aged home residents; (2) Enhance the quality of care in aged homes
Methodology :
YCH CGAT Working Group was formed to strengthen the communication and share incidents among the team. Several documents had been developed for guiding RCHE staff to ensure a standardized practice in RCHEs. On the other hand, CGAT had collaborated with different Clinical Management Teams e.g. CHP, ICT, Nurse Consultant, Pathology, Renal Team and Palliative Care Team to organize a lot of empowerment programs, training sessions and workshops for RCHE staff e.g.「太陽院舍」計劃 (2016),「腹膜透析知多少」及「腹膜透析護理工作坊」(2017) and「院舍感染控制及防跌」計劃之「防風行動」(2018). With the assistance of other specialties, activities were tailor-made to enhance the competence of RCHE staff. Moreover, crisis management is an essential part of quality care enhancement in RCHEs. Infectious disease outbreak or Medication incident were managed in RCHEs by CGAT. With the experience of outreaching care, CGAT nurses identify the possible cause and give preventive measures.
Result & Outcome :
In comparison between 07/08 and 17/18, positive results of the outcomes were achieved. Total no. of CGAT Attendance was increased from 24,017 to 41,099 (70%). Average A&E attendance rate was reduced from 14.7% to 10.4% (29%). Average E-admission rate was reduced from 11.8% to 11.4% (3%). Lastly, there were 1,035 hospital bed-days reduced each month after the establishment of YCH CGAT. YCH CGAT had significantly improved both performance indicators and service outcomes in RCHEs to reduce the pressure of hospital utilization.
Co-location with:
