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State of the art (1)

College for Geriatrics 1. State of the Art 2. Projects’ results Jean-Pierre Baeyens on behalf of the College for Geriatrics. State of the art (1). Peer review 2000: 103/160 geriatric units 13 admissions/bed/year (median) 50% admissions from private home 46% home discharge median age = 82 yrs

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State of the art (1)

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  1. College for Geriatrics1. State of the Art2. Projects’ resultsJean-Pierre Baeyens on behalf of the College for Geriatrics

  2. State of the art (1) • Peer review 2000: 103/160 geriatric units • 13 admissions/bed/year (median) • 50% admissions from private home • 46% home discharge • median age = 82 yrs • length of stay 22 days • median occupation rate 90% • multidisciplinary team J.P.Baeyens et al. BVGG 2000

  3. State of the art (2) • 21 formation centers • 37 fellow places available http://www.health.fgov.be/AGP/fr/professions/medecins/maitre_de_stage/specialites/geria.htm

  4. College ’s projects • 2000: peer review • 2001: nutrition • 2002: continence, emergency, radiotherapy • 2003: BMDS, AGGIR, ... • collaborations with the Colleges for: • radiotherapy • nephrology • emergency medicine

  5. OUTCOMES OF CONTINUOUS PROCESS IMPROVEMENT OF NUTRITIONAL CARE PROGRAM AMONG GERIATRIC UNITS IN BELGIUM Nutrition program 2001

  6. Observation comprehensive geriatric assessment and MNA routine nutrition Intervention comprehensive geriatric assessment and MNA « Flow Chart» « Meals on Wheels » approach Methodology: 2 phases 0 3 6 months Nutrition program 2001

  7. Conclusions • high prevalence of malnutrition among geriatric hospitalized patients • significant decreased hospitalization stay during 2nd phase (confounding factors ?) • significant increased PAB concentrations during 2nd phase J Gerontology 2004, In Press Nutrition program 2001

  8. DRIPDetect, Reduce, Incontinence, Programme Thierry Pepersack on behalf of the College for Geriatrics

  9. Discussion • 45% of incontinent patients in geriatric units • 26% of transient incontinence • functional incontinence represents more than half of the chronic situations • incontinence is associated with: • high length of stay • high proportion of demented patients Continence 2002

  10. 2003 - 2004Belgian Minimal Geriatric Screening Tools BMGST

  11. Rationale • the belgian geriatric program is associated with the obligation of continuous registration of quality variables • the ministry intends to ask us this registration • the College for Geriatrics and the Belgian Society for Gerontology and Geriatrics think it would be better to choose ourselves these variables among the comprehensive geriatric assessment

  12. Worksheet • Part I:2003 - questionnaire about Comprehensive Geriatric Assessment • Part II:2004 - consensus conference "Belgian Minimum Geriatric Screening Tools » • Part III:2005 - topics choice

  13. Part I Belgian Minimum Geriatric Screening Toolsfor Comprehensive Geriatric Assessment College for Geriatrics www.geriatrie.be

  14. Results • 59 questionnaires • acute and subacute G beds

  15. Comprehensive Geriatric Assessment • ADL • IADL • risk of falling • cognition • depression • social • nutrition • pain • QOL already used proposed for BMGS

  16. ConclusionsPart I • response rate • geriatricians : interested in CGA • transparency of geriatric units quality of questionnaire not enough CGA lack of uniformity CGA ~ no consensus

  17. Part II 2004Consensus Conference "Belgian Minimum Geriatric Screening Tools » College for Geriatrics www.geriatrie.be

  18. Working groups ADL-IADL P De Vriendt, G Dargent, C Swine MobilityJP Baeyens , Ghesquière CognitionM Lambert , E Gorus, C Sachem DepressionA Velghe, Th Pepersack Social JP Baeyens, H Vandekerkhof Nutrition T Pepersack, H Daniels,J Pétermans, C Gazzotti Pain N Vandennoorgate, A Pepinster FrailtyC Swine, G Dargent, P De Vriendt www.geriatrie.be

  19. Part III2005Topics choice College for Geriatrics www.geriatrie.be

  20. Results

  21. Priorities • geriatric programme • programmation of beds • adapted financial ressources • alternative services • day hospital • inpatients geriatric consultation service (multidisciplinary) • for geriatric problems (confusion, denutrition, falls, incontinence, etc.)

  22. Objectives quality partnership « education » and awareness campaign promotion of a broader health concept Ressources advisory board scientific society surveys (nutrition, continence, SEGA) comprehensive geriatrics focused on: maintenance of function and comfort presence of satisfactory support systems College ’s role

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