World Café 2
Reducing potentially avoidable ED visits

Tuesday, November 28, 2017
2:00 - 3:15 pm
In this interactive session, delegates will have a chance to network directly with presenters and attendees. Delegates can expect to pick up practical tools and resources, and have the opportunity to explore diverse perspectives and change ideas.


A Model for Implementing Infusion Therapy in LTC

The LTC Infusion Toolkit was created as a resource to Sienna LTC sites in the use of intravenous and hydration therapy for treatment and comfort care needs. The resources aim to promote resident centered care by allowing residents to be treated in the LTC home potentially avoiding ED transfers and/or facilitating timely return of the resident back to the LTC setting. With the increasing demand on LTC from the acute care setting to accept residents with IV's and the limited resources available from CCAC to support the program, we needed to develop a program to meet resident needs, address staff competencies and manage system challenges.

Deferring Transfers From Residential Care to Emergency Departments

The PREVIEW-ED Tool was designed specifically for Personal Support Workers (PSW) working in Long Term Care. Designed as an observational tool to be completed daily on each resident receiving care PREVIEW-ED assists PSWs to identify the subtle changes in resident conditions that may lead to health decline. The tool identifies decline in four key reasons for transfer to the Emergency Department. (congestive heart failure, pneumonia, dehydration, and urinary tract infections) 

A successful pilot of the tool deferred long term care Emergency Department transfers by 71% (n= 176) These results motivated Fraser Health to implement PREVIEW-ED in all of their 79 long term care homes both owned and operated and contracted. PREVIEW-ED helps avoid hospitalization by leveraging the observational skills and familiarity of direct care staff with the residents for whom they provide care. 

Taking only seconds to complete, the tool’s simple scale quantifies the change providing a common language for team communication and has been instrumental in improving communication and team functioning among care team members.

How to Improve Decision-Making in Ontario's Long Term Care Homes: The PoET (Prevention of Error-based Transfers) Project

The PoET (Prevention of Error-based Transfers) Project is an award-winning Ethics Quality Improvement Project that focuses on changing decision-making practices in long term care homes in Ontario so that residents' wishes, values, and beliefs are at the center, and health care professionals can more easily follow Ontario's Health Care Consent Act. Most consent-related decisions in Ontario's long term care homes are shaped by a particular form that encourages error-driven decisions; these errors can lead to treatment that residents might not want and might not benefit from, especially at end of life. By using a Quality Improvement approach participating long term care homes in the Central West LHIN have successfully removed this form and changed decision making practices so that residents' wishes, values and beliefs are asked about on admission and are then taken into consideration when consent-related decisions are made.

Speaker: Jill Oliver