Geriatric department measures lead to faster access to care for older people

Rumailah Hospital (RH), which provides specialised medical care for older adults, has initiated a comprehensive improvement management programme that enables faster access to geriatric outpatient (OPD) clinics for patients.

Dr Hanadi al-Hamad, medical director at Rumailah Hospital and Qatar Rehabilitation Institute, and chairperson for the Department of Geriatrics and Long-Term Care, explained that the impetus for the improvements was the desire to deliver enhanced age-appropriate care to older adults."Older patients often have multiple health issues, including chronic conditions that make them less resilient when dealing with illnesses,” she said.“Potential delays in receiving a diagnosis and treatment can exacerbate the problem and may lead to more serious complications,” Dr al-Hamad said. “It is therefore imperative that our older patients receive professional healthcare in a timely manner."Various teams responsible for delivering geriatric OPD services in Rumailah Hospital analysed the care delivery to identify opportunities for improvements.The work has led to a sustained reduction in the average appointment wait times in the geriatric OPD clinics.Hospital data from 2019-2020 showed a significant reduction of 34% in average appointment wait times for older patients seen in a geriatric outpatient clinic in Rumailah Hospital; this was in spite of a substantial increase in the number of patient referrals during this time.Dr Mahmoud Refaee, consultant in geriatric medicine at Rumailah Hospital, who was tasked with supporting the access improvement initiative, said that the team used a multipronged approach to enable faster patient access.“The improvement tracks included expansion of clinics (not only within the hospital but also across Hamad Medical Corporation (HMC) or primary care centres), establishment of temporary subspecialty clinics to manage higher caseloads, implementation of a robust electronic-triage system that reduced the risk of double referral, enabling bed-bound patients to receive care through home care services (to avoid their arduous journey to a hospital clinic), and the establishment of the Elderly Urgent Care Unit, which is immensely important for patients needing immediate clinical care without having to resort to visiting the Emergency Department,” he said.General geriatric clinics, which provide comprehensive geriatric assessment and medical care to patients who are older than 60 years with complex medical conditions, were able to shorten appointment wait times as part of the patient-centred care improvement efforts.Geriatric Falls Prevention clinics achieved a nearly 35 % reduction in average wait times.The clinic accepts patients aged 60 years and older who have experienced a “mobility impairment-related fall incident”.The Falls Prevention Clinic aims to enhance patient mobility while preventing falls and fractures through evidence-based clinical practice and research.This achievement was made possible by simultaneously expanding falls prevention services and clinics.Elderly patients referred from other HMC departments and Primary Health Care Centres to the Memory Clinic have benefited from a significant reduction of 57 % in average waiting time over the last two years.The Memory Clinic is a very successful service in Qatar that uses an integrated multidisciplinary approach to managing dementia and memory loss.The Geriatric Orthopedic Services clinic provides expert geriatrician and multidisciplinary team rehabilitation care for elderly patients with hip fractures and other bone-related issues.The service improvements implemented have resulted in a 23 % reduction in wait times from referral to consultation between 2019 and 2020."Our OPD geriatric clinics ensure high-quality specialised healthcare service delivery, inclusive of preventive, diagnostic as well as treatment services to people aged 60 and above,” Dr al-Hamad said. “In-line with the National Health Strategy goals on healthy ageing, our aim is to provide age-appropriate outpatient settings that are suited to the needs of our older patients.”“This has enabled faster access for older people to specialised geriatric care, which has an important impact on their health outcomes," she added.Rumailah Hospital is a multi-specialty facility that provides specialised care and services, including medical, surgical, physiotherapy, geriatric, and long-term care.