Specialized senior care delivers best outcomes in hospitals

Seniors receiving hospital care in acute care for elders units have shorter hospital stays, experience fewer declines in physical functioning and are less likely to be discharged to a nursing home than when treated in regular hospital units. This is one of the preliminary findings of a Canadian Institutes of Health Research-funded study led at York.

The researchers systematically screened more than 50,000 articles on existing studies of acute care for elders interventions, and included 63 different studies in either a narrative or meta-analysis.

York nursing Professor Mary Fox, the study’s principal investigator, unveiled the preliminary findings at York Central Hospital recently, while Michael Johnny of the Knowledge Mobilization (KMb) unit provided KMb strategies to help the hospital determine how to disseminate the information.

Mary Fox with participants at the unveiling at York Central Hospital
Above: Mary Fox with participants at the unveiling at York Central Hospital

The goal of the research is to develop senior-friendly hospitals by informing and engaging decision makers about the best interventions to prevent functional cognitive, social and physical decline in older adults when they are hospitalized. Seventy-five per cent of people age 65 and older have two chronic illnesses and that can lead to a sudden worsening of their condition requiring hospitalization, says Fox.

 Mary FoxRight: Mary Fox

“Sixty-two per cent of all day beds in acute care are filled with people 65 years of age and older and they make up only 13 per cent of the population. They really are the core care customer for acute care hospitals,” she says. “My role is to get the evidence and engage the decision makers and researchers in interpreting it for their context. We’re not just rolling it out, but engaging them from the very beginning so the information will be more useful.”

Deborah TregunnoLeft: Deborah Tregunno

The study also looked at what the system needs to provide and what interventions are needed to best serve seniors in acute care hospitals.

“I was interested in the study because there is really a lot of evidence that says when older people visit hospitals, they are at risk of experiencing bad outcomes,” says Fox. “The poor outcomes are not related to their illness, but to other things, like not getting up and walking around while in the hospital or not eating well. There are things that fall through the cracks.”

York Central Hospital is interested in knowing what those things are so they can provide even better care for older adults.

Professor Deborah Tregunno and Professor Malini Persaud, a former post-doctoral fellow, both of York’s School of Nursing in the Faculty of Health, along with York librarian IIo-Katryn Maimets and researchers from Ryerson University and the University of Toronto, were co-investigators of the study.

The team also included Michael Johnny, Andrea England, director of research and partnerships in the Faculty of Health, York adjunct librarian Angela Hamiton and decision-making partners Tiziana Rivera, chief practice officer at York Central Hospital, and Dr. Mary Ferguson-Paré, former vice-president of professional affairs and chief nurse executive at University Health Network.

By Sandra McLean, YFile writer