P.HO1, Y.LIM1, L.L.C.TAN1, G.MAGPANTAY1, J.W.K.CHIA1, L.K.SIM1, J.A.LOW1
Khoo Teck Puat Hospital1
Nursing Homes (NHs) are faced with a myriad of challenges to provide quality palliative care to residents who are at their end-of-life (EOL). We aim to describe and examine the impact of the GeriCare Palliative Care Program, which comprises of telemedicine, on-site clinical preceptorship, palliative care education program and Advance Care Planning (ACP) advocacy in reducing emergency department (ED) transfers from NHs.
This is a retrospective cohort study. A total of 217 telemedicine consults were conducted for 187 unique NH residents across 5 NHs in Singapore over a 27-month period from April 2018 to June 2020. Records of all enrolled palliative care residents who were triaged via telemedicine consultations were examined.
Our findings revealed that 82% of our urgent telemedicine consultations have successfully averted ED transfers. Gender and completion of ACP were statistically significant between ED transfer group and non-ED transfer group. Among those who completed their ACP, 78.3% of the ED transfer group chose limited intervention as their main goals of care as compared to 30% in the non-ED transfer group.
The GeriCare Palliative Care Program is a novel program, which is developed to improve the quality of palliative care in NHs. The comprehensive GeriCare model comprises of a systematic framework, an integration of clinical support, ACP advocacy and education program. Our findings demonstrated that these interventions synergistically led to a reduction in ED transfers while optimising the residents’ quality of care. By carrying out the targeted initiatives to support NHs, the residents could age-in-place comfortably.