industry & policy
What are some of the key changes GEDI has brought about for elderly patients and the staff who care for them? One of the big outcome measures, if you like, for emergency departments, is how many people wait for more than four hours to receive medical care.
In addition, obviously emergency departments are supposed to be efficient and cost-effective, so in our research we have looked at these kinds of hospital markers of outcomes. Are we getting people through the system quickly and efficiently and getting them to see the medical care that they need, and are we doing it in a way that is, at the very worst, cost-neutral and hopefully cost-saving?
Of course, from the patient’ s point of view, are we doing this in a way that they are satisfied with this and it doesn’ t mean they keep bouncing back to hospital?
With the GEDI, with this focus on this particularly vulnerable population of frail elderly people, we are seeing improvements in hospital efficiency and cost-effectiveness, but also we’ re beginning to see great outcomes from patients as well. They’ re actually spending less time waiting and they’ re returning to hospital less frequently.
However, these are only preliminary results, and our final research won’ t be available until early in 2017.
You’ ve received state funding to have the program rolled out on a wider scale. What are the next steps there, and how can other organisations be involved? When we have got the final results and we are sure that this is a cost-efficient and effective service, we will be working with Queensland Health on a dissemination project. This is where we will actually send to emergencies departments a toolkit that we are developing that will be able to be disseminated to Queensland Health facilities, Queensland Health emergency departments, that will have everything: all the paperwork they need, all the strategies they need, where the funding needs to come from, and how to approach this.
We’ re also working on a bigger toolkit that can be applied to non- Queensland Health facilities, and we hope eventually to get some sort of funding to actually run facilitation programs. Because it’ s not just about having all the right pieces of paper and all of the processes that you can tick a box. It’ s actually about having clinicians with the right skills and attitudes and enthusiasms as well.
GEDI is part of a larger project, CEDRiC, or Care Coordination through Emergency Department Residential Aged Care and Primary Health Collaboration. The initiative aims to improve interaction between aged-care facilities and hospitals. How’ s the wider project been going? It’ s going really well. As you rightly say, GEDI is one aspect of that. Actually, the GEDI program deals not just with people coming in from aged care, but any frail, older person, whether they live at home or in a residential aged-care facility. But the CEDRiC project is particularly looking at improving care for people in residential aged care.
We have developed the role of the nurse practitioner candidate – a program to train nurse practitioners to work in the residential aged-care facility.
We will be analysing the results of that aspect of the CEDRiC project early in [ 2017 ]. We hope that by about February we will be able to report the results.
Our preliminary analysis is showing that, generally, we’ re getting some very good qualitative outcomes. People are very happy and satisfied with the services, and we just want to crunch the numbers to make sure that it’ s also efficient and cost-effective. ■
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