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The Pieces of the Puzzle in Optimizing Medications: 48/6
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The Pieces of the Puzzle in Optimizing Medications: 48/6


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Presented by David Thompson at the Optimizing Medications workshop in Vancouver

Presented by David Thompson at the Optimizing Medications workshop in Vancouver

Published in: Health & Medicine

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  • 1. Optimizing Medications Linkage to 48/6 CCM January 16, 2014 David Thompson, VP Seniors Care & Clinical Support Services Co-Chair, Provincial Seniors Hospital Care Working Group
  • 2. Objectives of Presentation • Some History on 48/6. • Overview of Seniors Hospital Care Working Group • Linkage of 48/6 to Other Initiatives • Implementation Overview 2
  • 3. Why Focus On Seniors Care in Hospital • Majority of acute care discharges are seniors. • 60% of all inpatient bed days. • 83% of total ALC cases. • 69% of admissions through the ED. • Improving outcomes for seniors increases system capacity for everyone. • Initial focus was on five areas in first 48 hours of admission: • Delirium/Cognition • Appropriate Medication Use • Functional Mobility • Nutrition/ Hydration • Bowel/Bladder 3
  • 4. Provincial Seniors Hospital Care Working Group • Formed in 2011 as a working group under the Health Operations Committee (HOC). • Representatives from each health authority and Ministry of Health. • Co-Chaired by a health authority representative and ministry representative. • Focus on improving hospital care for seniors. 4
  • 5. SHCWG Areas of Focus and Priorities Areas of Focus: • Integration, Education, Communication Priorities: • Going home better, note worse. • Delivery of strong, basic clinical care. • Develop an enabling environment. • Promote independence upon discharge. • Longitudinal care management. 5
  • 6. SHCWG Outcomes • Engagement with BC Patient Safety & Quality Council. • Shared experiences of work happening related to seniors care in hospital. • Understanding linkages to other priorities of the Ministry. • Completion of Annual Work plan Priorities 6
  • 7. What is 48/6? Seniors in Hospital Care (48/6) CCM GOAL • Prevent disability and deterioration of seniors in acute care. • 48/6 refers to six guideline screenings that are to be completed within 48 hours of admission. 1. Functional Mobility 2. Nutrition and Hydration 3. Bowel and Bladder Control 4. Medication Management 5. Cognition: Delirium/ Dementia (prevention, detection, and management) 6. Pain Management 7 7
  • 8. 48/6 CCM • SHCWG view that 48/6 is different from other CCMs. • Requires a culture change and significant engagement. • 48/6 is about good screening, assessment and care planning to improve patient outcomes. • Ministry of Health launched 48/6 CCM in October of 2012. 8
  • 9. 48/6 Process Steps 1. An initial assessment of presenting complaint is completed using a standardized approach. 2. Within first 48 hours of admission, assessment of all 48/6 modalities is completed with direct input from multidisciplinary team members. 3. Patient specific care plan is written with multidisciplinary input. 4. Care Plan reviewed and updated daily based on changing patient status. 9
  • 10. Link to Seniors Action Plan • Ministry of Health launched Seniors Action Plan with clear deliverables and time-lines. • 48/6 supports the Seniors Action Plan related to creation of standardized guidelines for care of seniors in hospital. 10
  • 11. Summary • Can significantly improve care for seniors in hospital. • Focus good screening, assessment and care planning. • Dove-tails with some significant information system enhancements within HA’s. • Opportunity to work collaboratively to improve seniors care. • Opportunity to standardize processes of care to create a consistent patient experience. 11