Developing new hospital-at-home models based on Comprehensive Geriatric Assessment: Implementation recommendations by the Working Group on Hospital-at-Home and Community Geriatrics of the Catalan Society of Geriatrics and Gerontology / Desarrollo de nuevos modelos de hospitalización a domicilio basados en la valoración geriátrica integral: recomendaciones del grupo de trabajo de Hospitalización a domicilio y geriatría comunitaria de la Sociedad Catalana de Geriatría y Gerontología para su implementación

Last decade, the Government of Catalonia have urged an integrated care strategy for planning the care model to older populations living with frailty, multimorbidity and advanced illnesses. Based on international evidence that was reviewed by a group of experts from the Catalan Society of Gerontology and Geriatrics, we summarised some recommendation to adapt hospital-at-home care to older populations in our system. We defined Comprehensive Geriatric Assessment (CGA) hospital-at-home (HaH) as a specialised home hospitalisation service formed by interdisciplinary teams, characterised by using the clinical methodology of CGA, and by adapting geriatric units’ protocols for the provision of person-centred care at home. Main benefits of CGA-HaH in these populations are: response to heath crises according to individualised care plans based on the situational diagnosis carried out by Primary Care teams; provision of a comprehensive health and social approach tailored to the complexity of cases and situations; and adaptation of multipurpose hospitalisation, by working on different person-centred care, aspects, such as caregivers support on care provision, focusing on function or home adaptation. (AU)

En la última década el gobierno de Cataluña ha diseñado un plan estratégico de atención integrada para planificar la atención del subgrupo de pacientes mayores con fragilidad, multimorbilidad y enfermedad avanzada, con la intención de mejorar la salud y el manejo clínico. Guiándonos en la evidencia internacional, revisada por un grupo de expertos de la Societat Catalana de Geriatria i Gerontologia, revisamos recomendaciones para adaptar los modelos a la población mayor de nuestro sistema. Así, definimos la hospitalización a domicilio geriátrica o basada en la valoración geriátrica integral (VGI) como una hospitalización a domicilio especializada basada en equipos interdisciplinares que utilizan la VGI como instrumento de trabajo de manera similar a las unidades de hospitalización geriátricas. Estas intervenciones ofrecen beneficios en responder a crisis de salud dando continuidad al diagnóstico situacional y a los planes individualizados planteados por los equipos de atención primaria, en realizar una valoración integral de la complejidad en todos sus aspectos, y en ofrecer una hospitalización integral centrada en la persona, trabajando aspectos como el apoyo a los cuidadores en la atención, la recuperación funcional y la adaptación del domicilio. (AU)

Developing new hospital-at-home models based on Comprehensive Geriatric Assessment: Implementation recommendations by the Working Group on Hospital-at-Home and Community Geriatrics of the Catalan Society of Geriatrics and Gerontology.

Last decade, the Government of Catalonia have urged an integrated care strategy for planning the care model to older populations living with frailty, multimorbidity and advanced illnesses. Based on international evidence that was reviewed by a group of experts from the Catalan Society of Gerontology and Geriatrics, we summarised some recommendation to adapt hospital-at-home care to older populations in our system. We defined Comprehensive Geriatric Assessment (CGA) hospital-at-home (HaH) as a specialised home hospitalisation service formed by interdisciplinary teams, characterised by using the clinical methodology of CGA, and by adapting geriatric units' protocols for the provision of person-centred care at home. Main benefits of CGA-HaH in these populations are: response to heath crises according to individualised care plans based on the situational diagnosis carried out by Primary Care teams; provision of a comprehensive health and social approach tailored to the complexity of cases and situations; and adaptation of multipurpose hospitalisation, by working on different person-centred care, aspects, such as caregivers support on care provision, focusing on function or home adaptation.