232 / 290
Key conclusions:
(1) In order to kick off integrated care reform in a
locality it is necessary to provide awareness raising to all parties
involved and the population as well as the means that will cover the
reform cost and assure sustainability of operations in the long run.
(2) For that it is necessary to run a social enterprise in a PPP form, to
manage the Territorial Care Hub that will centralize organization,
coordination, management and delivery of all Long TermCare services.
(3) This structure should not depend on neither health nor social
policy central authorities for better response and efficiency and should
be run locally by a new institution built to cover health, prevention
and care for at least the primary and long term care services of
the population. If secondary healthcare can also be aligned with
hospitals and clinics this would be better, but it concerns usually
advanced integrated care systems, aligned care costs reimbursement
and abundance of state resources and investments, 4) Investment,
innovative financing and business innovation is necessary for any
community care structure that wants to run sustainable care opera-
tions in the long run without crises, (5) the first priorities to imple-
ment integrated long term care by order of priority are: a. leadership
awareness and on-the-job training b. Deliberation of the integrated
LT care plan with all the local health ecosystem stakeholders, not only
those concerned by health sector. The vision, strategy and action plan
have to be endorsed by the entire ecosystem c. build the right
investment blend until the Care Hub is sustainably run with constant
RoI d. the Care Hub management has to be not for profit, independent
from central authorities and abide to local control for commissioning
services e. Workforce training in additional to care skills and patient
empowerment are key for the success of this model.
P-746
Efficacy of a nursing home GP service in London
K. Tully.
Sternhall Lane Surgery
For the past 2 years a team of GPs in South East London have been
providing a dedicated primary care service to local nursing homes. The
services involves regular geriatrician and multidisciplinary team input
and much work on advance care planning. To measure our impact one
of the factors we looked at was the rates of avoidable emergency
admissions to hospitals and
“
Accident & Emergency
”
attendances. We
compared the rates from 2013/2014 (before the service was commis-
sioned) with the rates in 2014/2015 and found a reduction of 23% and
24% respectively. We conclude from these figures that this is a cost
effective model of providing good quality care for the elderly in the
community. (Poster presentation would include graphs and elaborate
on the details of the service)
P-747
Adult ventilator weaning program in tertiary care center Qatar
S. Acharath valappil, H. Al hamad, E. Al sulaiti, A. Darwish,
N. Nadukkandiyil, M. Refae, F. Umminiyattle, M. Al husami, O. Idris,
J. Liza, G. Fawzy, G. Al tamimi, Z. Ben hassine, G. Khouri.
Hamad Medical
Corporation, Doha, Qatar
Introduction:
It was realized that many ICUs and acute beds in Hamad
Medical Corporation hospitals in Qatar were occupied by Long term
mechanically
–
ventilated patients who were otherwise medically
stable. These patients were previously scattered in different units that
made the task of providing optimal care very difficult. Once these
patients are transferred to Rumailah hospital adult ventilator unit, it
became apparent that there was an ideal opportunity to wean some of
these patients off the ventilators thus improving their prognosis.
Methods:
Aim is to cohort the chronic ventilated patients to single
specialized unit for early weaning process. An Adult ventilator wean-
ing team was formed comprising of physician, nurse and respiratory
therapist. After initial assessment in acute care hospital, patients were
admitted to adult ventilator unit. Patient is assessed by the weaning
team, starts weaning trial if patient is fit for weaning. This is followed
by family conference and multi-disciplinary team conference leading
to successful discharge or transfer to the wards.
Results:
Total 104 cases were disposed till March 2016, among these
40 cases identified as weanable from ventilator, and 24 cases were
successfully weaned and discharged or transferred.
Conclusions:
The program has implemented the best of evidence
based medicine and created customized care plans for each patient
that has led to the significant improvements. The program has
achieved success in weaning, one patient/month with active rehabili-
tation with an annual Cost savings: $ 2500 per year /patient.
P-748
The IBenC Project
−
benchmarking costs and quality of European
community care
H.G. van der Roest
1
, A. Declercq
2
, V. Garms-Homolová
3
, G. Onder
4
,
H. Finne-Soveri
5
, P.V. Jónsson
6
, J.H. Smit
7
, J.E. Bosmans
8
, H.P.J. van
Hout
1
.
1
VU University medical center, Amsterdam, The Netherlands;
2
University of Leuven, Leuven, Belgium;
3
Hochschule für Technik und
Wirtschaft Berlin, Berlin, Germany;
4
Università Cattolica Sacro Cuore,
Rome, Italy;
5
National Institute for Health and Welfare, Helsinki, Finland;
6
University of Iceland, Reykjavik, Iceland;
7
GGZInGeest, Amsterdam,
The Netherlands;
8
VU University Amsterdam, Amsterdam, The
Netherlands
Introduction:
High quality community care may prove to be a cost
effective solution for the future in comparison with institutio-
nalization. Insight into which type of community care delivery
provides the best outcomes against reasonable costs is lacking. The
IBenC (Identifying best practices for care-dependent elderly by
Benchmarking Costs and outcomes of community care) project is a
cross-European study with the aim to identify best practices in
community care for care-dependent elderly people, by benchmarking
the cost-effectiveness of community care delivery systems in Europe.
A new benchmarking method will be developed, based on a
standardized comprehensive geriatric assessment instrument, the
Resident Assessment Instrument for Home Care (interRAI-HC).
Methods:
The study has a prospective longitudinal design. Data
collection took place amongst community care recipients of 65 years
and older in Belgium, Finland, Germany, Iceland, Italy, and the
Netherlands. To enable an in-depth interpretation of best performing
practices, the contexts and characteristics of community care
organizations and community care staff are studied cross-sectional.
Results:
At baseline 38 community care organizations, 2884 commu-
nity care clients, and 1086 community care professionals were
included in the study. First results on the study population and the
benchmarking method will be presented.
Key conclusions:
The project will provide health care policy makers
comprehensive insight into the functioning of the European commu-
nity care systemby taking into account patient outcomes, costs of care,
organizational performances, and into the role that structure and care
processes of care organizations plays in care performance.
P-749
Healthy active ageing supported by technological environment:
the DOREMI experience
F. Vozzi
1
, L. Fortunati
2
, C. Gallicchio
3
, F. Palumbo
2
, A. Micheli
3
,
S. Chessa
3
, E. Ferro
2
, O. Parodi
1
.
1
Institute of Clinical Physiology, IFC-CNR,
2
Institute of Science and Information Technology, ISTI-CNR,
3
Department
of Computer Science, University of Pisa, Pisa, Italy
Introduction:
European population aging requires the design of
innovative solutions able to support, in term of quality and time, its
health status. DOREMI project has developed an innovative platform
able to stimulate and monitor elder people as also to be customized on
user requirements.
Methods:
34 older people (age 65
–
80 years) were involved in UK
and Italy DOREMI trials (3 months). Subjects were characterized at
baseline in terms of physical activity (SPPB, PASE test, daily steps/
meters, 6MWT), hemodynamic and biochemical parameters (blood
pressure, HR, lipid profile, glycaemia, etc.), dietary habits (caloric
intake) and balance assessment (BERG scale). Through the DOREMI
Poster presentations / European Geriatric Medicine 7S1 (2016) S29
–
S259
S226