{"id":987,"date":"2024-04-10T10:02:19","date_gmt":"2024-04-10T14:02:19","guid":{"rendered":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/?post_type=chapter&#038;p=987"},"modified":"2024-04-10T10:06:50","modified_gmt":"2024-04-10T14:06:50","slug":"2-4-5","status":"publish","type":"chapter","link":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/chapter\/2-4-5\/","title":{"raw":"2.4.5 ED Diversion","rendered":"2.4.5 ED Diversion"},"content":{"raw":"<ul>\r\n \t<li>Hospitalization rates are 65% higher for seniors with dementia than for those without dementia<\/li>\r\n \t<li>More than 340,000 seniors at risk of frailty are admitted to hospital yearly<\/li>\r\n \t<li>Of these seniors, 2x are more likely to die within 1yr of discharge<\/li>\r\n<\/ul>\r\nCommon conditions for LTC ED visits:\r\n<ul>\r\n \t<li>Need for emergent diagnostic imaging and laboratory date to guide treatment<\/li>\r\n \t<li>Congestive heart failure exacerbation<\/li>\r\n \t<li>Infectious causes<\/li>\r\n \t<li>Falls<\/li>\r\n \t<li>Gastrointestinal Concerns[footnote]Canadian Institute for Health Information, n.d.-a[\/footnote][footnote]Canadian Institute for Health Information, 2022a[\/footnote][footnote]Latham &amp; Ackroyd-Stolarz, 2014[\/footnote]<\/li>\r\n<\/ul>\r\n<div class=\"textbox textbox--exercises\"><header class=\"textbox__header\">\r\n<p class=\"textbox__title\">Optional Reading<\/p>\r\n\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n<ol>\r\n \t<li><a href=\"https:\/\/www.cihi.ca\/en\/a-profile-of-hospitalized-seniors-at-risk-of-frailty-in-canada-infographic\">A profile of hospitalized seniors<\/a><\/li>\r\n<\/ol>\r\n<\/div>\r\n<\/div>\r\nWhat can be done to prevent ED transfer and admission?\r\n<ol>\r\n \t<li>Improved communication surrounding goals\r\n<ul>\r\n \t<li>Goes beyond FULL Code\/DNR<\/li>\r\n \t<li>Should be reassessed regularly, reflective of prognosis and priority should be to limit\/avoid harm<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>Educating families\/residents\r\n<ul>\r\n \t<li>Educate re. benefits vs. risks of hospital transfer so that families\/residents have confidence in the level of treatment within LTC<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>Routine rounding \u2013 guided by primary staff\r\n<ul>\r\n \t<li>Allows capturing of changes early to prevent decline<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>Working with community partners\r\n<ul>\r\n \t<li>Nurse Practitioner Led Outreach Team<\/li>\r\n \t<li>Home and Community Care<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>Analyze data\r\n<ul>\r\n \t<li>Determine the main conditions requiring ED transfer and implement strategies to manage[footnote]Health Quality Ontario, 2023[\/footnote]<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ol>","rendered":"<ul>\n<li>Hospitalization rates are 65% higher for seniors with dementia than for those without dementia<\/li>\n<li>More than 340,000 seniors at risk of frailty are admitted to hospital yearly<\/li>\n<li>Of these seniors, 2x are more likely to die within 1yr of discharge<\/li>\n<\/ul>\n<p>Common conditions for LTC ED visits:<\/p>\n<ul>\n<li>Need for emergent diagnostic imaging and laboratory date to guide treatment<\/li>\n<li>Congestive heart failure exacerbation<\/li>\n<li>Infectious causes<\/li>\n<li>Falls<\/li>\n<li>Gastrointestinal Concerns<a class=\"footnote\" title=\"Canadian Institute for Health Information, n.d.-a\" id=\"return-footnote-987-1\" href=\"#footnote-987-1\" aria-label=\"Footnote 1\"><sup class=\"footnote\">[1]<\/sup><\/a><a class=\"footnote\" title=\"Canadian Institute for Health Information, 2022a\" id=\"return-footnote-987-2\" href=\"#footnote-987-2\" aria-label=\"Footnote 2\"><sup class=\"footnote\">[2]<\/sup><\/a><a class=\"footnote\" title=\"Latham &amp; Ackroyd-Stolarz, 2014\" id=\"return-footnote-987-3\" href=\"#footnote-987-3\" aria-label=\"Footnote 3\"><sup class=\"footnote\">[3]<\/sup><\/a><\/li>\n<\/ul>\n<div class=\"textbox textbox--exercises\">\n<header class=\"textbox__header\">\n<p class=\"textbox__title\">Optional Reading<\/p>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li><a href=\"https:\/\/www.cihi.ca\/en\/a-profile-of-hospitalized-seniors-at-risk-of-frailty-in-canada-infographic\">A profile of hospitalized seniors<\/a><\/li>\n<\/ol>\n<\/div>\n<\/div>\n<p>What can be done to prevent ED transfer and admission?<\/p>\n<ol>\n<li>Improved communication surrounding goals\n<ul>\n<li>Goes beyond FULL Code\/DNR<\/li>\n<li>Should be reassessed regularly, reflective of prognosis and priority should be to limit\/avoid harm<\/li>\n<\/ul>\n<\/li>\n<li>Educating families\/residents\n<ul>\n<li>Educate re. benefits vs. risks of hospital transfer so that families\/residents have confidence in the level of treatment within LTC<\/li>\n<\/ul>\n<\/li>\n<li>Routine rounding \u2013 guided by primary staff\n<ul>\n<li>Allows capturing of changes early to prevent decline<\/li>\n<\/ul>\n<\/li>\n<li>Working with community partners\n<ul>\n<li>Nurse Practitioner Led Outreach Team<\/li>\n<li>Home and Community Care<\/li>\n<\/ul>\n<\/li>\n<li>Analyze data\n<ul>\n<li>Determine the main conditions requiring ED transfer and implement strategies to manage<a class=\"footnote\" title=\"Health Quality Ontario, 2023\" id=\"return-footnote-987-4\" href=\"#footnote-987-4\" aria-label=\"Footnote 4\"><sup class=\"footnote\">[4]<\/sup><\/a><\/li>\n<\/ul>\n<\/li>\n<\/ol>\n<hr class=\"before-footnotes clear\" \/><div class=\"footnotes\"><ol><li id=\"footnote-987-1\">Canadian Institute for Health Information, n.d.-a <a href=\"#return-footnote-987-1\" class=\"return-footnote\" aria-label=\"Return to footnote 1\">&crarr;<\/a><\/li><li id=\"footnote-987-2\">Canadian Institute for Health Information, 2022a <a href=\"#return-footnote-987-2\" class=\"return-footnote\" aria-label=\"Return to footnote 2\">&crarr;<\/a><\/li><li id=\"footnote-987-3\">Latham &amp; Ackroyd-Stolarz, 2014 <a href=\"#return-footnote-987-3\" class=\"return-footnote\" aria-label=\"Return to footnote 3\">&crarr;<\/a><\/li><li id=\"footnote-987-4\">Health Quality Ontario, 2023 <a href=\"#return-footnote-987-4\" class=\"return-footnote\" aria-label=\"Return to footnote 4\">&crarr;<\/a><\/li><\/ol><\/div>","protected":false},"author":517,"menu_order":34,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-987","chapter","type-chapter","status-publish","hentry"],"part":3,"_links":{"self":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters\/987","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/users\/517"}],"version-history":[{"count":3,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters\/987\/revisions"}],"predecessor-version":[{"id":990,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters\/987\/revisions\/990"}],"part":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/parts\/3"}],"metadata":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters\/987\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/media?parent=987"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapter-type?post=987"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/contributor?post=987"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/license?post=987"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}