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Learning Integrated Health System to Mobilize Context-Adapted Knowledge With a Wiki Platform to Improve the Transitions of Frail Seniors From Hospitals and Emergency Departments to the Community (LEARNING WISDOM): Protocol for a Mixed-Methods Implementation Study

2020; JMIR Publications; Volume: 9; Issue: 8 Linguagem: Inglês

10.2196/17363

1929-0748

Patrick Archambault, Josée Rivard, Pascal Y. Smith, Samir K. Sinha, Michèle Morin, Annie LeBlanc, Yves Couturier, Isabelle Pelletier, El Kebir Ghandour, France Légaré, Jean‐Louis Denis, Don Melady, Daniel Paré, Josée Chouinard, Chantal Kroon, Maxime Huot‐Lavoie, Laetitia Bert, Holly O. Witteman, Audrey-Anne Brousseau, Clémence Dallaire, Marie‐Josée Sirois, Marcel Émond, Richard Fleet, Sam Chandavong,

Frailty in Older Adults

Elderly patients discharged from hospital experience fragmented care, repeated and lengthy emergency department (ED) visits, relapse into their earlier condition, and rapid cognitive and functional decline. The Acute Care for Elders (ACE) program at Mount Sinai Hospital in Toronto, Canada uses innovative strategies, such as transition coaches, to improve the care transition experiences of frail elderly patients. The ACE program reduced the lengths of hospital stay and readmission for elderly patients, increased patient satisfaction, and saved the health care system over Can $4.2 million (US $2.6 million) in 2014. In 2016, a context-adapted ACE program was implemented at one hospital in the Centre intégré de santé et de services sociaux de Chaudière-Appalaches (CISSS-CA) with a focus on improving transitions between hospitals and the community. The quality improvement project used an intervention strategy based on iterative user-centered design prototyping and a "Wiki-suite" (free web-based database containing evidence-based knowledge tools) to engage multiple stakeholders.