Yesterday we hosted a team from Joseph Brant Hospital in Burlington who are interested to start their own hospital geriatric-friendly.
“We are at a transition point” they said. (I am sure many MANY hospitals are at this point!)
We started the day by attending the meeting of the “Geriatric steering committee” of the hospital. Although I have been attending these meeting monthly since the beginning of my fellowship, I did not know a lot about the history of the committee and how it first started.
It started with a few folks: physicians and nurses. They had one thing in common: they were (and still are) passionate about geriatric care. They had the mission to find who else is passionate and bring them in the circle. Together, they can brainstorm, bring new ideas, implement projects, elaborate research study, and spread their enthusiasm and ambition. They got together because they realized that care provided to older adults were suboptimal and even damageable. Everyone had this strange idea that older adults belong in a mythic other place… But this place does not exist. They decided that this mythic place has to be “here”. Here is the hospital, the emergency department and the community. They worked together to create this whole circle of care and slowly they became the pride of the hospital, even the brand.
Michael Mills, hospitalis at Joseph Brant Hospital asked this: “What are the not expensive, low-technology tricks and recipes to make older adults stronger rather then frailer after a hospital stay?” The answer: a lot. In fact, almost everything is low cost because the most important things are a change of philosophy, education, partnerships, policies and a few non expansive supplies. Partnerships is crucial for sustainability. The principle of “what’s in it for me” is the key for good relationship and mutual efforts. Also, sharing successes and stories helps to recruit new partnerships and sustain changes. In the end, the hospital switched from an acute care centre to a hospital that meet patient’s needs!
Sinai Health system is now a model of care. Not because of technology or beautiful rooms and flooring but because of the people. These passionate and creative team working health care professionals that I am proudly working and learning with.
So, if you want to change things, get yourself a crew. Start small with the right people then try to involve as many department and health care professionals as possible. Do not forget to include administration (they hold the budget!) Meet monthly. One project at the time. One success at the time. Oh and a failure can become an even bigger success later. Start improving care and streamline. It is the same principle with medication and older adults: start low, go slow but get somewhere!
Good luck! And if you want to get inspired, I promise you that a visit at Mount Sinai with us will do the trick!
Geriatric Emergency Medicine 