Page 151 - Hospital Authority Convention 2017

Symposiums

S7.2 Geriatric Care 09:00 Convention Hall C

Frail Elderly Care Model in Emergency Medicine Ward, Queen Elizabeth Hospital
Wong G
Accident and Emergency Department, Queen Elizabeth Hospital, Hong Kong HOSPITAL AUTHORITY CONVENTION 2017
The population in Hong Kong reached more than 7.3 million in 2016, and is expected to rise to 8.2 million in 2043. During the
same period, the elderly population (aged over 65) rose from 16% in 2016 to 23% in 2024, and then 33% in 2044. Over the
decade, Yau Tsim Mong area as well as Kowloon District experienced the largest population growth; and Wong Tai Sin district
has the highest proportion of elderly population.

It is no wonder that the Accident and Emergency Department (AED) of Queen Elizabeth Hospital is experiencing increasingly
heavy service demand – the highest triage categories one to three attendance, highest number of inpatients by ambulance,
and most importantly highest elderly attendance by those aged 65 and above. In order to uphold the quality of care to our
patients, new service and care model have been devised – Emergency Medicine Ward (EMW) is one major endeavor among
the AEDs in Hong Kong. Over the years, EMW has proven to be a suitable platform for protocol-driven care plan, as well as a
hub for multi-disciplinary service and cross-specialty collaboration to expedite patient management.

Frail Elderly Care Model is not new to healthcare system in other parts of the world. The opening of our second EMW by the
end of year 2015 has provided opportunity for trial of this service model – Frail Elderly Service. This model incorporates
multi-disciplinary team management of emergency physicians and nurse, geriatric-trained nurses, and allied health
professionals. The Frailty Team will target medical problems as well as psycho-social needs of the elderly, who may be
suffering from psychosomatic complaints, mobility imbalance and frequent fall, caring problems etc. The comprehensive
team approach will expedite the in-hospital management with shortened length of stay and also decongest the hospital as a
whole. The recruitment of a geriatrician to the Team recently will further strengthen the Team’s professional expertise, enable
safe discharge and divert patients to the most appropriate level and area of care in the system.

S7.3 Geriatric Care 09:00 Convention Hall C

Frailty – Implications for Urgent Care of the Older Person
Kng C
Department of Geriatrics, Ruttonjee and Tang Shiu Kin Hospitals, Hong Kong

Elderly people accounting for more than half of the emergency admissions are core business of hospitals. Thus, quality care
must address the specific needs of this vulnerable population, characterised by multi-morbidity, disability and frailty. The
foremost challenge is to identify those with the highest risk of adverse outcomes for individualised treatment approaches in a
heterogeneous population. Increasing complex therapeutic options using a disease-centred paradigm shifts our focus of care
towards treatments of conditions, rather than care of the person. This is pertinent at the advanced stage of chronic illness
that compassionate comfort measures are more appropriate. Frailty is a phenotypic or biophysical state which provides a
risk measure of poor health outcome. Clinically applied, this has practical implications in guiding care plan and stratifying Wednesday, 17 May
treatment options for all healthcare professionals caring for the elderly.
This session will describe practical applications of frailty to drive improvements in delivering care to elderly in local acute
settings. This includes early geriatric assessment which informs care planning in admissions avoidance and expediting
discharges. It will describe initial efforts to make the patient journey, environment and care processes “frail-friendly” as
countermeasures to reactive episodic care.

149