Eastern Health (NL)

  • Lisa Adams, Project leader, Commission of Inquiry, Eastern Health, St. John's, Newfoundland 

Educating for a Senior Friendly Hospital and Efficient ER

Health care systems of today face a challenging climate that is inundated with complex patient needs and other system pressures. As fiscal restraints loom, the duty to do the best that healthcare professionals can possibly do for the patient is challenged by increased workloads, scarce resources and an aging demographic. Mentally-ill seniors are frequent users of the busiest and most expensive sector of an acute care hospital, the ER department. However, the practice and knowledge of clinicians, prevailing stigma of patients and clinicians, the presentation of mental illness in seniors and the non-conducive environment of the busy ER department often create challenges that can further jeopardize the mental health of seniors. The use of advanced technology on how to accurately assess mentally-ill seniors in a speedy, efficient, accurate and thorough manner can be instrumental to help attending ER room clinicians accurately assess, diagnose and treat mentally-ill seniors to optimize their quality of care in the most fiscally responsible, feasible and sustainable manner possible. It is believed that this intervention project is pivotal to help begin the workings needed for a senior friendly ER department. Because seniors with mental illness often present frontline clinicians with challenges related to assessment, diagnosis and treatment they are often under- assessed, diagnosed and treated, and end up with lengthy hospitalizations. The provision of an assessment tool in the form of a computer application that frontline emergency clinicians use should help them assess, diagnose and treat seniors with mental illnesses coming into the emergency room. Developing senior friendly hospitals and using technology to advance the care of mentally-ill seniors holds great potential to meet the needs of seniors and enhance their quality of life. However, critical change management processes are integral to that process to ensure success.    

ER clinicians acknowledge that their educational backgrounds and experience are limited when caring or trying to care for seniors with mental illnesses. They realize the importance a computer application assessment tool would have to enhance their ability to better care for this population of seniors, however, the rushed and busy pace of the ER, the increased workload, and the presence of the influenza epidemic detracts from using the assessment tool. Despite these challenges, there needs to be more accountability from them in servicing some of the most complex patients, inclusive of seniors with mental illness.