European Geriatric Medicine - Supplement 1 - Volume 7 - October 2016

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Bari-Italy (AAB) for a multicenter survey on to determine the needs
and preferences of caregivers for improving the assistance of dementia
patients, and guiding technological development of MARIO.
Methods: A six minute video on technological devices and functions
of MARIO was showed, and all caregivers fulfilled a 43-item question-
naire that explored four areas: A) Acceptability, B) Functionality,
C) Support devices, and D)Impact.
Results: Caregivers declared that to facilitate acceptance (within
60.4%) and to improve functionality of MARIO (within 52.8%) should
be important/likely/useful.
Within 65.9% of caregivers reported that following support devices in
MARIO could be useful for their patients: (1) for monitoring bed-rest
and movements, (2) for monitoring the medication use, (3) for
monitoring the ambient environmental conditions, (4) for regulating
heating, humidity, lighting and TV channel, (5) for undertaking
comprehensive geriatric assessment, (6) for link to care planning, (7)
for monitoring physiological deterioration, and (8) for monitoring
cognitive deterioration.
Within 64.5% of caregivers declared that MARIO should be useful to
improve quality of life, quality of care, safety, emergency communica-
tions, home-based physical and/or cognitive rehabilitation programs,
and to detect isolation and health status changes of their patients.
Conclusions: MARIO is a novel approach employing robot compa-
nions, and its effect will be: (1) to facilitate and support persons with
dementia and their caregivers, and (2) reduce social exclusion and
isolation.
P-723
Improving the quality of discharge summaries for older patients
D.J. Forster, S.E.L. Gilson. Hampshire Hospitals Foundation Trust
Introduction: Discharge summaries are often the only communica-
tion between secondary and primary care following hospital admis-
sion. It is crucial they are completed, with adequate information,
especially for patients with multiple comorbidities and functional
impairment. The Academy of Medical Royal Colleges issued “A
Clinicians Guide to Record Standards” indicating what discharge
summaries should include.
Methods: Details of all patients over 80 on a given day across 5 medical
wards were collected. When available, discharge summaries were
reviewed using AClinicians Guide to Record Standards as our standard.
Re-audit using the same methods occurred 4 months later, following
the introduction of a new discharge summary format and depart-
mental teaching highlighting the importance of discharge summaries.
Results: 120 patients were sampled in cycle 1. 113 discharge
summaries were available. 129 patients were sampled in cycle 2,
with 73 discharge summaries available at the time of sampling. 34%
discharge summaries used the new format. Improvements were seen
in completion of diagnosis on discharge (92 –98%); past medical
history (50–75%); explanation of medication changes (68–81%);
functional status (35 –39%); resuscitation status (3–36%) and follow
up plans (85 –89%). Where the new format is used, all standards were
met except for explanation of medicine changes (94%) and functional
status (56%).
Key conclusions: The old discharge summary is still being used. When
used, almost all standards are met with the new format. Focus is now
on increasing use of this and including functional status when it is
updated.
P-724
Appropriateness of emergency department visits of older
population living nursing homes (75 Year old and over) in
Chambery’ s hospital
N. Marques1, E. Barnay1, V. Scolan2, M. Maignan2, S. Perrin-Besson 2,
F. Trinchero1, E. Dubie1, P. Lesage1, G. Gavazzi2. 1Tertiary hospital of
Chambéry, France; 2University Hospital of Grenoble-Alpes
Introduction: The attendance of emergency department (ED) by
the older population who are dependent is constantly increasing.
This study analyzed the consultation of ED by elderly who are 75
years or older, coming from nursing homes, and described the
inappropriate ones.
Method: Descriptive retrospective epidemiological study conducted
from January to June 2014 at the ED of Chambéry Hospital. The
assessment of relevance was performed on a grid of explicit criteria
with the French version of the Appropriateness Evaluation Protocol
(AEPf). The distinction between irrelevant admissions (AEPf-) and the
relevant ones (AEPf +) was done and then two experts independently
overrode the AEPf−.
Results: 465 admissions were included.136 (29,2%) were AEPf− . The
AEPf− were less polymedicated (83% versus 68%; p = 0,0003). Their
hospitalization rate was lower (43% versus 77%, p < 0,001). Out of the
136 AEPf−, 17 were finally considered as justified (12,5%), 60 (44%)
unjustified by experts and 59 (43,5%) were subject of disagreement
(k = 0,16, p < 0,0001). For the unjustified group, diagnostic or thera-
peutic advice was the main needed expertise at ED. After the
override, preventability rate was 13,7% according to geriatrician,
versus 24,7% for the ED expert.
Conclusion: The admissions of patients from nursing homes were
deemed irrelevant for 29,3% of cases. Experts confirm that half of them
were not relevant for ED admission. The preventability rate was
assessed differently depending on whether the expert is a geriatrician
(13,7%) or an Emergency Physician (24,7%).
P-725
How to create a geriatric outpatient care
J. Gorjão Clara1,2, L.M. Batista1, S. Estevão1, F. Parreira1, S. Fernandes 1.
1Hospital CUF Descobertas, 2Faculty of Medicine of University of Lisbon,
Lisbon, Portugal
Objective: With the increase of the life expectancy, the prevention and
treatment of aging-associated diseases became a challenge for
healthcare professionals. According to literature, specialized health
services for elderly patients are still an area in development in
Portugal, although the awareness of this need have increased greatly
in the last years. To address this problematic, a multidisciplinary
geriatrics outpatient care was created in a private hospital, which until
then only existed in a public hospital. The applied model, based on the
Comprehensive Geriatric Assessment, has been used in Faculty of
Medicine of University of Lisbon for five years. To make this model
useful to those who would want to follow it, this study describes the
methodology and the indicators used during clinical evaluation. This
work could serve as an example of aworkflow to be replicated in other
health care units, contributing also to improve the practices and
teaching of geriatric care in Portugal.
Methods: Being a Type II or III patient is the main inclusion criteria.
Due to the multidisciplinary character of the outpatient care, patients’
evaluation is done in a multiple-step procedure. A set of assessment
scales is applied, being the collected data evaluated statistically. The
last step comprehends the combined analysis of all the outputs, aiming
to adapt the treatment to the patient’s needs. The satisfaction level and
health improvement is evaluated posteriorly through standardized
questionnaires.
Conclusion: Despite being a new service, preliminary results indicate
improvements in the patients’ quality of life and in the customization
of their clinical care.
P-726
Exploring staff training in the use of monitoring technologies in
care homes
A. Hall1, C. Brown Wilson2, E. Stanmore1, C. Todd1. 1University of
Manchester, UK; 2University of Queensland, Brisbane, Australia
Introduction: This study explores facilitators and barriers to imple-
mentation of monitoring technologies in nursing and residential care
homes for people with dementia.
Methods: AYinian case study approach [1], with participants recruited
from three dementia-specialist care homes in North-West-England.
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S219