Authors (including presenting author) :
Cheng SY(1),Chan PK(1),Wong CL(1), Ng YB(1), Sha KY(1), Sim TC(1)
Affiliation :
(1)Medical & Geriatric Department, United Christian Hospital.
Introduction :
Seasonal flu occurs every year and stresses the medical system. Elderly are at high risk to be infected and this can result in adverse consequences and suddenly increase hospitalization or even death. Additionally, when their unplanned readmission rate soars, the demand for medical services will further aggravate. Currently, we only provide comprehensive discharge plan for elderly patients with Harrpe score ≥0.2 in medical wards in United Christian Hospital. Therefore, Medical Pilot Program (MEDPP) was conducted to provide comprehensive discharge plan and health education for elderly flu patients with Harrpes <0.2 during Winter Surge, and aimed to reduce their chance of unplanned readmission rate (URR).
Objectives :
To evaluate the effectiveness of MEDPP on reducing the URR by: 1) Stabilize the medical conditions of elderly patients with flu after discharge. 2) Support patients and their relatives to cope with the community rehabilitation process. 3) Empower patients and their caregivers in self-protection against influenza.
Methodology :
MEDPP was conducted in two acute wards during Winter Surge from 22/1/2018 to 30/4/2018. Elderly (age ≥ 60 years) patients with Harrpe score < 0.2 and flu positive were recruited. Interventions Part I: The Admission and Discharge Plan Form (ADPF) was used to assess whether Case Manager (CM) and/or Home Support Team (HST) services should be referred. Part II: Face-to-face health education including influenza prevention and Community Health Services such as General Outpatient Clinic (GOPC) Telephone Appointment System and the Patient Support Call Center (PSCC) service. Outcome measures included a) URR ≤28days, b) satisfaction surveys, and c) 2018/2019 influenza vaccination statuses.
Result & Outcome :
54 patients were assessed. Only 11 patients were eligible for CM care. No URR among 2 /11 patients who were enrolled in the CM care or solitary patients who received the HST service. 17% of solitary patients without HST services were readmitted within 28 days. After health education, 74% of patients showed confidence in using the GOPC Telephone Appointment System. Number of active PSCC users who learned how to use the service increased by 60%. 63% of patients said that influenza prevention education is useful. Overall, 96% of patients said that health education strengthened their community self-care capabilities. At least 10% new cases received 2018/2019 flu vaccination before 1/1/2019. Conclusion: Comprehensive discharge plan and adequate health education are essential for elderly and their family caregivers from hospital to home . It can prevent adverse events, higher quality of care and lower the re-hospitalization rate.
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