scholarly journals 213 A New Way of Memory Care in an Integrated Care HUB

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Catherine Murphy ◽  
John Cooke ◽  
Riona Mulchay ◽  
George Pope ◽  
Maggie Bolger ◽  
...  
Keyword(s):  
Integrated Care ◽  
Cognitive Rehabilitation ◽  
Care Pathway ◽  
Memory Loss ◽  
Positive Outcome ◽  
Resource Room ◽  
Qualitative Feedback ◽  
Memory Care ◽  
Memory Clinics ◽  
The Right

Abstract Background The Occupational Therapy (OT) service in the integrated care HUB team was established in January 2018. Prior to this, there was an established memory clinic, however with inconsistent access to OT. The streamlining and structuring of memory clinics further highlighted the need for post-diagnostic support for example individual sessions focusing on memory education and practical strategies to enable independence in daily activities. The integration of OT enabled person-centred strategies to be provided to individuals experiencing memory loss. Methods A retrospective analysis was completed comparing the number of OT memory patient contacts between January to June 2018 and November 2018 to April 2019 also reflecting the memory care pathway developed during this period. OT assessed all new patients experiencing memory difficulties that impacted on functional activities to initiate referral process. In April 2018, the Memory Technology Resource Room (MTRR) opened and the OT HUB using to facilitate patient contacts. The design/implementation of cognitive rehabilitation groups in May 2018 added another step to pathway. Dementia cafés were established in public cafés in the city and county area, sponsored by local care provider, also supported by HUB team. Feedback was gathered from surveys given to individuals, carers and HUB team in the Café and MTRR. Results From January to June 2018 there were 50 memory streamed patient contacts completed by the OT. From November 2018 to April 2019, 206 patient contacts were completed. These include both individual and group cognition focused sessions. Positive qualitative feedback was retrieved from attendees to MTRR and Café all indicating at least one positive outcome from post-diagnostic supports and services. Conclusion A multi-domain cognitive OT service when initiated by an integrated care HUB proves to be an effective and acceptable memory care pathway. The development of this holistic pathway enabled the person to be seen in the right place, at the right stage of their journey with memory difficulties.

FRI0512 INTEGRATED CARE NETWORK AS A BUILDING STONE FOR SUSTAINABLE AND COMPREHENSIVE CARE FOR PATIENTS WITH ARTHRALGIA

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 855.1-855
Author(s):  
E. Van Delft ◽  
K. H. Han ◽  
J. Hazes ◽  
D. Lopes Barreto ◽  
A. Weel
Keyword(s):  
Primary Care ◽  
Usual Care ◽  
Integrated Care ◽  
Usual Care Group ◽  
Inflammatory Arthritis ◽  
Care Setting ◽  
Primary Care Setting ◽  
Care Group ◽  
Care Network ◽  
The Right

Background:Western countries experience an increasing demand for care, particularly for inflammatory arthritis (IA), while the healthcare budget decreases1. The innovative value-based primary care strategy2includes integrated care networks, where primary and secondary care bundle their expertise to improve patient value by providing the right care at the right place.General practitioners (GPs) have difficulties recognising IA, leading up to only 20% IA diagnoses of all newly referred arthralgia patients. However, since IA needs to be treated as early as possible to overcome progression, it is worthwhile to analyse whether integrated care networks have an impact on patient outcomes and cost-effectiveness. Triage by a rheumatologist in a primary care setting is one of the most promising integrated care networks for efficient referrals3.Objectives:To assess the effect of triage by a rheumatologist in a primary care setting in patients suspect for inflammatory arthritis.Methods:The present study follows a cluster randomized controlled trial design. The intervention, triage by a rheumatologist in a local primary care centre, will be compared to usual care. Usual care means that patients are referred to a rheumatology outpatient clinic based on the opinion of the general practitioner.The primary outcome is the frequency of IA diagnoses assessed by a rheumatologist. Patient reported outcome measures (PROMs (EQ-5D)) and costs (work productivity (iPCQ) and healthcare utilization (iMCQ)) were determined at baseline, after three, six and twelve months. The target was to include 267 patients for each study group (power level 0.8). Since this study is still ongoing we can only show first results on the efficiency of referrals.Results:In the period between February 2017 and December 2019 a total of 543 participants were included; 275 in the usual care group and 268 in the triage group. Mean age (51.3 ± 14.6 years) and percentage of men (23.6%) were comparable between groups (page=0.139; psex=0.330).The preliminary data show that the number of referred patients in the triage group is n=28 (10.5%) (Fig. 1). 32 patients (11.9%) were not referred directly but advice was given for additional diagnostics. Since all patients in the usual care group were referred there is a decrease of at least 77.6% in referrals when rheumatologists are participating in the integrated practice units.Preliminary data on diagnosis are available for all referred patients in the triage group and for n=137 (49.8%) in the usual care group at this point. In the triage group n=18 (64.2%) of referred patients were diagnosed with IA (6.7% of the total study population). In the usual care group this was n=52 (38.0%) of the patients yet diagnosed.Conclusion:These preliminary results of an integrated care network are promising. Approximately three-quarters of all patients can be withheld from expensive outpatient care. PROMs data and cost-effectiveness analysis will give clear answers in order to provide evidence whether this integrated care network can be implemented as a standard of care.References:[1] Rijksoverheid. (2018). Bestuurlijk akkoord medisch-specialistische zorg 2019 t/m 2022.https://www.rijksoverheid.nl/.[2] Porter ME, Pabo EA, Lee TH. (2013). Redesigning Primary Care: a strategic vision to improve value by organizing around patients’ needs. Health affairs, 32(3);516-525[3] Akbari A, et al. (2008). Interventions to improve outpatient referrals from primary care to secondary care. Cochrane Database Syst Rev, 4,CD005471.Disclosure of Interests:None declared

Views of First Nation Elders on Memory Loss and Memory Care in Later Life

2010 ◽  
Vol 25 (4) ◽  
pp. 317-342 ◽  
Author(s):  
Wendy Hulko ◽  
Evelyn Camille ◽  
Elisabeth Antifeau ◽  
Mike Arnouse ◽  
Nicole Bachynski ◽  
...  
Keyword(s):  
Memory Loss ◽  
Later Life ◽  
First Nation ◽  
Memory Care

Patient quality criteria for a multidisciplinary integrated care pathway for von Hippel-Lindau syndrome

2021 ◽  
Vol 79 ◽  
pp. S295
Author(s):  
R. Giles ◽  
K. Dreijerink ◽  
R.S. Van Leeuwaarde ◽  
A.N. Van Der Horst-Schrivers ◽  
T.P. Links
Keyword(s):  
Integrated Care ◽  
Care Pathway ◽  
Quality Criteria ◽  
Von Hippel Lindau ◽  
Integrated Care Pathway ◽  
Von Hippel Lindau Syndrome

Design of customized VR serious games for the cognitive rehabilitation of retrograde amnesia after brain stroke

2021 ◽  
pp. 1-36
Author(s):  
Daniel Lanzoni ◽  
Andrea Vitali ◽  
Daniele Regazzoni ◽  
Caterina Rizzi
Keyword(s):  
Retrograde Amnesia ◽  
Serious Games ◽  
Cognitive Rehabilitation ◽  
Ecological Validity ◽  
Memory Loss ◽  
Medical Personnel ◽  
Patient Specific ◽  
Specific Test ◽  
Real Objects ◽  
Brain Stroke

Abstract The paper presents a software platform to design serious games for the rehabilitation of severe memory loss by means of Virtual Reality (VR). In particular, the focus is on retrograde amnesia, a condition affecting patient's quality of life usually after brain stroke. At present, the standard rehabilitation process includes showing pictures of patient's familiar environments to help recovering the memory. The proposed rehabilitation platform aims at developing patient-specific serious games for memory loss starting from the 3D scanning acquisition of familiar environments. The Occipital Structure Sensor and the Skanect application have been used for the virtualization of the real objects and the environment. A modular procedure has been designed to interface the virtual objects of each acquired environment with the modules of the game-logic developed with Unity. In addition, the developed solution makes available a set of software modules for the patient's monitoring and the data management to automatically generate medical reports, which can be easily connected to each new patient-specific serious game. A specific test has been performed to assess the main features of the VR platform and its usability. A positive feedback has been given by the involved medical personnel, who highlighted the importance of objective data to improve the ecological validity of the cognitive rehabilitation for retrograde amnesia.

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