It is well known that Queensland has a growing and ageing population. According to statistics, by 2036 people aged 65 years and older will account for 20 per cent of the population.
Much has been done to better meet the needs of older people, including CEQ’s Improving the quality, safety, and care of older Queenslanders program. The program is broad, encompassing care of the older person across many healthcare settings as well as the Frail Older Persons’ Collaborative which aims to optimise the care of frail older adults. The Collaborative defines frailty as “a state of increased vulnerability, associated with but distinct from increasing age and multi-morbidity, resulting in disproportionate adverse health outcomes following a stressor” which is now the agreed definition used across Queensland Health.
Dr Helen Brown, Deputy Director-General Clinical Excellence Queensland, said the Collaborative team used a co-design approach with key stakeholders to identify areas that could improve care. “A co-design methodology was used to identify areas for improvement that could be scaled statewide to transform care of the frail older person but in a sustainable way,” she said. “Four priority areas were identified, and evidence-based interventions were chosen for each priority area and implemented across metropolitan and regional areas in Queensland.”
The areas include:
- a Residential Aged Care Facility acute care Support Service (RaSS)
- improved early identification and management of frail older persons presenting to hospital emergency departments (GEDI)
- optimisation of inpatient care (EAT WALK ENGAGE – internal access only)
- enhancement of advance care planning.
In a paper recently published in the Journal of the Australian Healthcare and Hospitals Association, Collaborative members Elizabeth Whiting, Ian Scott, Laureen Hines, Tamara Ward, Ellen Burkett, Erin Cranitch, Alison Mudge, Elizabeth Reymond, Andrea Taylor, and Ruth Hubbard on behalf of the Frail Older Persons’ Collaborative Program explored the statewide implementation of the interventions. Laureen, Director in CEQ’s Healthcare Improvement Unit, said the team conceptualised the healthcare system as a ‘complex adaptive system’, characterised by many different but interconnected parts.
“Queensland has successfully implemented evidence-based interventions on a scale that to our knowledge, is unsurpassed nationally. We wanted to look at how that was achieved, what were the success factors?” Laureen said. “Changing culture and practice is challenging, but we have identified seven key factors that contributed to a successful implementation. Specifically, when you have commitment from clinicians, high-level leadership, and adequate resources, effecting change in a complex environment is possible.”
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