Implantación de un programa de Geriatría de enlace coordinado con Atención Primaria en 60 centros sociosanitarios del área asistencial noroeste de la Comunidad de Madrid / Implementation of a Geriatric liason team in coordination with Primary Care attending 60 nursing homes in the northwest community healthcare network of the Community of Madrid

Objetivo: Describir las intervenciones incluidas en la implantación de un programa multidisciplinar de Atención Primaria, Salud Pública, centros sociosanitarios de forma coordinada con un servicio de Geriatría y el apoyo de otros servicios hospitalarios. Métodos: Estudio descriptivo observacional que se realizó en un área con 60 residencias y 4.600 residentes entre el 1-6-2020 y el 1-10-2021. El programa se dividió en diferentes intervenciones que implicaron el empleo de telemedicina y coordinación con un equipo de Geriatría de enlace. Se realizó también una estimación de costes evitados con la intervención de videoconsultas-telemedicina y por la intervención de los tratamientos intravenosos que se pautaron en residencia calculada a través de los Grupos Relacionados con Diagnóstico (GRD). Resultados: La actividad que se registró incluyó 2.247 correos electrónicos recibidos de residencias, 11.502 llamadas telefónicas, se realizaron 313 visitas médicas, en las que se valoraron 4.085 pacientes de forma integral, y se pautó tratamiento intravenoso a 422 pacientes en sus centros, empleando 7.541 fármacos, de los cuales 5.850 fueron antibióticos. La reducción de costes estimada según los GRD de los pacientes que se trataron en sus residencias fue de aproximadamente 1.500.000€ y 2.800 días de estancia hospitalaria evitados. Con las primeras videoconsultas que se realizaron a 198 pacientes se estimó una reducción de costes de 37.026€. Se creó un grupo de trabajo multidisciplinar del paciente institucionalizado en el hospital.Conclusiones: Este programa garantiza una mejora en la coordinación y continuidad entre los centros sociosanitarios, Atención Primaria, Salud Pública y Geriatría en colaboración con el resto del hospital y la Consejería de Sanidad, el cual a su vez y de forma secundaria reduce costes (AU)

Objective: To describe interventions included in the implementation of a multidisciplinary Geriatrics Program that gives support to nursing homes, in coordination with Primary Care and Public Health, in collaboration with other hospital departments. Methods: An observational descriptive study was conducted in an area that includes 60 nursing homes with nearly 4600 residents from June 1 st, 2020 to October 1 st, 2021. The program consists of different interventions including Telemedicine and support of a Geriatric Consultation Liaison Team. An estimation of avoided costs through these interventions was carried out. Results: The activity recorded was 11502 telephone calls, 2247 e-mails, 313 visits to these centres in where 4085 patients underwent comprehensive geriatric assessment. During this period of time 442 patients received intravenous therapy in their nursing homes, including 7541 different types of medication which 5850 of them were antibiotics. According to the Diagnosis-related-Group (DRG) of the patients that received intravenous treatment in their nursing homes, was estimated a cost reduction of 1,500,00€ and a total of 2800 days of hospital stay avoided. In the group of 198 patients that received video consultation was estimated reduction of costs of 37,026€. A hospital multidisciplinary care team focused on the nursing home patients was created. Conclusions: This program improves continuity of nursing homes patients care and to enhance communication and coordination among Primary Care, Hospitals and Public Health services and secondarily, reducing hospital costs (AU)

[Implementation of a Geriatric liason team in coordination with Primary Care attending 60 nursing homes in the northwest community healthcare network of the Community of Madrid]. / Implantación de un programa de Geriatría de enlace coordinado con Atención Primaria en 60 centros sociosanitarios del área asistencial noroeste de la Comunidad de Madrid.

OBJECTIVE: To describe interventions included in the implementation of a multidisciplinary Geriatrics Program that gives support to nursing homes, in coordination with Primary Care and Public Health, in collaboration with other hospital departments. METHODS: An observational descriptive study was conducted in an area that includes 60 nursing homes with nearly 4600 residents from June 1 st, 2020 to October 1 st, 2021. The program consists of different interventions including Telemedicine and support of a Geriatric Consultation Liaison Team. An estimation of avoided costs through these interventions was carried out. RESULTS: The activity recorded was 11502 telephone calls, 2247 e-mails, 313 visits to these centres in where 4085 patients underwent comprehensive geriatric assessment. During this period of time 442 patients received intravenous therapy in their nursing homes, including 7541 different types of medication which 5850 of them were antibiotics. According to the Diagnosis-related-Group (DRG) of the patients that received intravenous treatment in their nursing homes, was estimated a cost reduction of 1,500,00€ and a total of 2800 days of hospital stay avoided. In the group of 198 patients that received video consultation was estimated reduction of costs of 37,026€. A hospital multidisciplinary care team focused on the nursing home patients was created. CONCLUSIONS: This program improves continuity of nursing homes patients care and to enhance communication and coordination among Primary Care, Hospitals and Public Health services and secondarily, reducing hospital costs.

Conciliación de la medicación al ingreso y alta hospitalaria. Una experiencia consolidada / Medication reconciliation at admission and discharge. A consolidated experience

La conciliación de la medicación es actualmente una de las principales estrategias para reducir los errores de medicación relacionados con la transición asistencial. Objetivo. Describir una metodología de trabajo que permita garantizar la continuidad asistencial del paciente en relación con la farmacoterapia, al ingreso y al alta hospitalaria. Material y método. Se describe la metodología implantada en un hospital de tercer nivel y los principales resultados de la conciliación de medicación al ingreso y alta de pacientes mayores de 75 años en el Servicio de Traumatología durante el año 2014. Resultados. Las fases de la metodología fueron: 1. obtención de la historia farmacoterapéutica (al menos 2 fuentes de información); 2. análisis de discrepancias y validación de la medicación al ingreso: se realizó un check list para estandarizar el proceso; 3. comunicación del perfil farmacoterapéutico: se diseñó un formulario en la historia clínica electrónica; y 4. conciliación de la medicación al alta hospitalaria e información al paciente: entrega de esquema posológico y recomendaciones al paciente. Aplicando esta metodología, en 2014 se conciliaron 318 pacientes ingresados en traumatología (294 al ingreso y alta). El 35,5% presentó al menos un error de conciliación. La media de errores por paciente conciliado fue de 0,69. En el 74,1% de los pacientes se entregó información escrita al alta. Conclusiones. Esta metodología ha permitido establecer un flujo de trabajo que facilita la coordinación interprofesionales; disminuir los errores de medicación y dar respuesta a uno de los principales problemas de la continuidad asistencial (AU)

Medication reconciliation is currently one of the main strategies to reduce medication errors related to transitional care. Objective. To describe a method that would ensure continuity of patient care as regards drug therapy from admission to discharge. Methods. A description is presented on the methodology implemented in a tertiary hospital and the main results of medication reconciliation at admission and discharge of patients older than 75 years in the Trauma Unit during 2014. Results. The phases of the methodology were: 1. Obtain medication history (at least two sources of information); 2. Analysis of discrepancies and validation of medication on admission: A checklist was made to standardise the process, 3. Report on the pharmacotherapeutic profile: a form was designed in electronic medical records, and 4. Medication reconciliation at discharge and patient information: presenting the dosing schedule and recommendations to the patient. The medication of 318 patients admitted to Trauma was reconciled (294 at admission and discharge) by applying this methodology during the study period. There was at least one medication reconciliation error in 35% of cases. The mean error per patient reconciled was 0.69. Written discharge information was given to 74.1% of patients. Conclusions. This methodology has allowed a workflow to be established that facilitates coordination between healthcare providers, in order to reduce medication errors and to respond to one of the main problems of continuity of care (AU)

[Medication reconciliation at admission and discharge. A consolidated experience]. / Conciliación de la medicación al ingreso y alta hospitalaria. Una experiencia consolidada.

UNLABELLED: Medication reconciliation is currently one of the main strategies to reduce medication errors related to transitional care. OBJECTIVE: To describe a method that would ensure continuity of patient care as regards drug therapy from admission to discharge. METHODS: A description is presented on the methodology implemented in a tertiary hospital and the main results of medication reconciliation at admission and discharge of patients older than 75 years in the Trauma Unit during 2014. RESULTS: The phases of the methodology were: 1. Obtain medication history (at least two sources of information); 2. Analysis of discrepancies and validation of medication on admission: A checklist was made to standardise the process, 3. Report on the pharmacotherapeutic profile: a form was designed in electronic medical records, and 4. Medication reconciliation at discharge and patient information: presenting the dosing schedule and recommendations to the patient. The medication of 318 patients admitted to Trauma was reconciled (294 at admission and discharge) by applying this methodology during the study period. There was at least one medication reconciliation error in 35% of cases. The mean error per patient reconciled was 0.69. Written discharge information was given to 74.1% of patients. CONCLUSIONS: This methodology has allowed a workflow to be established that facilitates coordination between healthcare providers, in order to reduce medication errors and to respond to one of the main problems of continuity of care.

Resultados de la aplicación del protocolo de prevención de la infección por Clostridium difficile en una unidad geriátrica de agudos / Results of the application of a prevention protocol for Clostridium difficileinfection in an acute geriatric unit

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