公共卫生与医院合作,改善急诊科对弱势老年人的过渡护理。

Lauren T Southerland, Carolyn Dixon, Shameka Turner, Kalih M West, Tameka Hairston, Tony Rosen, Caroline Rankin
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引用次数: 0

摘要

背景:居住在社区的老年人是社会服务需求得不到满足的高危人群。我们介绍了一种新颖的合作方式,即在急诊科(ED)中设置县级服务机构的个案经理,在为老年人提供医疗服务的同时,将他们与社区服务联系起来:环境:干预措施:干预措施:俄亥俄州富兰克林县老龄化办公室(OA)的个案经理被派驻到急诊科。OA 团队与急诊室社工团队合作,识别居住在社区的老年患者,进行上门入院评估,并启动所需的社区服务(包括送餐上门、应急响应系统、房屋维修和交通)。详细报告了计划逻辑模型和发展情况:从 2023 年 6 月到 12 月,≥60 岁的成年人共接受了 7284 次急诊室就诊。转介给 OA 个案经理的人数从每天 1 人到 13 人不等。OA 个案经理共对 252 名患者进行了全面的入院评估。其中 51% 为男性。目前只有 11%(n = 28)的患者获得了 OA 服务,而在已经获得 OA 服务的患者中,29%(n = 8)的患者需要更多服务。在其余未连接的患者(n = 224)中,8%(n = 20)不是本县居民,OA 小组将他们连接到了本县其他 OA。半数 53%(n = 120)的患者接受了服务,并在急诊室就诊期间接受了 OA 或其他社区健康计划提供的服务。OA 小组新转介了 3 名成人保护服务人员和 1 名长期护理监察员。该计划并未增加急诊室的住院时间或入院率:在社区急诊室内嵌入县级服务登记是一项成本中立的干预措施,可惠及以前未接受过服务的人群。未来的计划包括扩展该计划并评估该计划检测虐待老人和自我忽视的能力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A public health/hospital partnership to improve Emergency Department transitions of care for vulnerable older adults.

Background: Community-dwelling older adults are at high risk for unmet social service needs. We describe a novel partnership embedding county services case managers in the Emergency Department (ED) to connect older adults to community services alongside their medical care.

Methods: Setting: A medium-sized urban ED with 55,000 patient visits a year.

Intervention: Case managers from the Franklin County, Ohio Office on Aging (OA) were embedded within the ED. The OA team worked with the ED social work team to identify community-dwelling older patients, perform an in-person intake assessment, and initiate needed community services (including home-delivered meals, emergency response systems, house repairs, and transportation). Program logic model and development are reported in detail.

Results: From June to December 2023, there were 7284 ED visits for adults ≥60 years old. Referrals to the OA case manager ranged from 1 to 13 per day. The OA case managers performed 252 full intake assessments on unique patients. The population was 51% men. Only 11% (n = 28) were currently connected to OA services, and of those already connected 29% (n = 8) needed increased services. Of the remaining unconnected patients (n = 224), 8% (n = 20) were not county residents and the OA team connected them with other county OAs. Half 53% (n = 120) were accepting of services and had services from the OA or other community health programs initiated during the ED visit. The OA team made three new Adult Protective Services referrals and one referral to the long-term care ombudsman. The program did not increase ED length of stay or hospital admission rates.

Conclusions: Embedding county service enrollment within a community ED is a cost neutral intervention that reached a population without previous services. Future plans include expansion of the program and evaluation of the program's ability to detect elder mistreatment and self-neglect.

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