No abstract

Healthcare organizations and governments are exploring new methods to deliver cost-effective, quality care to the frail elderly. Given the projected increase in Canada's elderly population, ensuring that residents receive the right care, at the right time, in the right location is pivotal to this goal. Practical Routine Elder Variants Indicate Early Warning for Emergency Department has been developed as a quality improvement tool. Two pilot studies, one in Ontario and one in British Columbia, have shown promising results. Health leaders in acute care will benefit from improved Emergency Department (ED) utilization and less congested bed flow. Long-term care leaders can achieve fewer transfers to the ED, better quality outcomes, reduced costs from ED-acquired iatrogenic complications, enhanced communication with families, and improved staff confidence and morale. The health system benefits include reduced costs from fewer transfers and complications and enhanced collaboration between healthcare sectors.

The introduction of coordinated geriatric and discharge planning services was associated with a decrease in the percentage of beds occupied by patients awaiting long-term care in both teaching and community hospitals.

No abstract

All three cost-saving initiatives--the creation of a one-page application form to streamline the rehabilitation application process, the use of the resource specialist to assist with applications, and the development of an information package on cardiac rehabilitation--reflect a process whereby a creative idea, generating planning, activities, and follow-up resulted in a measurable effective change in practice. This process truly translated strategy into action (Kaplan, 1996) and is vital to the current rethinking in health care of how best to do our work (Coan, 1994). Because of this process, social workers in the cardiovascular surgical division of the cardiac program are better equipped to respond to the psychosocial needs of a growing cardiac population in a fiscally restrained environment.