Page 141 - HA Convention 2015

Symposiums

S7.1 Rehabilitation in Community 13:15 Convention Hall B

A Comprehensive Approach to Ambulatory Rehabilitation Tuesday, 19 May
Poulos CJ
School of Public Health and Community Medicine, The University of New South Wales, Australia

The rising cost of medical and hospital care as a result of population ageing requires the development of less costly
ambulatory models of care, including rehabilitation. Ambulatory rehabilitation does not have the iatrogenic risks of
hospitalisation and may be more convenient and contextually relevant for patients and their carers. For the purposes of this
presentation, ambulatory rehabilitation includes all service types that do not incorporate an overnight hospital stay.

The principles behind an ambulatory rehabilitation episode of care are essentially the same as that of an inpatient
programme: patient centred; goal directed; time limited and multidisciplinary. Programmes can be highly specialised and
tertiary, or less intensive and less costly, with a focus on restorative care and reablement. Interdisciplinary therapy provision
may be appropriate for less intensive episodes.

Used effectively, ambulatory rehabilitation, especially restorative and reablement models, provides the opportunity to expand
the purview of rehabilitation into chronic disease management and maintaining and improving function in older people.

When considering the most appropriate ambulatory rehabilitation model to employ, consideration needs to be given to
the patient’s health condition, location, patient and carer preference and resources, and funder requirements. Perverse
incentives from restrictive funding models can be barriers to the development of ambulatory models.

S7.2 Rehabilitation in Community 13:15 Convention Hall B

20 Years of Community Geriatric Assessment Service: The Past and the Future HOSPITAL AUTHORITY CONVENTION 2015
Wong CP
Private Practitioner, Hong Kong

The Community Geriatric Assessment Team (CGAT) was established in 1994 with funding from the Bureau of Health and
Welfare. But years before then, Hospital Authority and the Social Welfare Department had gone through negotiations in an
attempt to follow the Australian model of Community Geriatric Assessment Service, however ended up with dead ends due
to some significant inter-departmental relationship and ownership problems. The Ruttonjee Geriatric Service took the lead
in breaking the ice by pioneering a mini scale outreaching service to nearby Nursing Home in May 1993, and spearheaded
a new model of a comprehensive geriatric outreaching service to provide a seamless care between hospital care and
residential care. In this presentation, the critical success factors leading to almost 100% coverage of all nursing homes in
Hong Kong by the Hospital Authority Geriatric Teams, which is unique in the world will be highlighted. It significantly reduced
hospital readmission of elderly and broke the revolving door phenomenon. A future strategy is also suggested for further
development based on the 20 years of success.

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