Abstract
Introduction: As life expectancy increases, the proportion of older adults in Ireland is steadily increasing. There are currently 742,300 older adults in Ireland and that number is expected to increase to 1.56 million by 2051. However, these projected increases in life expectancy do not equate to increases in “healthy life expectancy”, with latter years often characterised by age-related multi-morbidity due to one or more chronic diseases. This may result in a reduction in quality of life and increasing cost to health care utilisation and budgets. This increased incidence in multi morbidity, along with older adult populations demonstrating lower thresholds for accessing acute care, has resulted in increasing numbers of older adults accessing acute and emergency care.
The National Integrated Care for Older Persons (NICPOP) is leading out on the development of end to end pathways across primary, secondary and acute services for older people with a specific focus on those with complex health needs. The Carlow Kilkenny Integrated Care Programme for Older Persons (ICPOP) was established in 2021 and aims to facilitate integration and collaborative delivery of services for older persons, acting as a co-ordinator of integrated care in tandem with public and private health and social care providers.
Aim & Objectives: To engage multiple stakeholders in a rapid improvement event (RIE) promoting collaborative evaluation, planning and service development that in turn facilitates the delivery of an improved model of integrated care for older persons in Carlow-Kilkenny.
Methods: •All public and private social and healthcare providers working with older persons in Carlow/Kilkenny were invited to participate or provide representation.
- Elements of the Lean methodology were adopted to facilitate multi stakeholder workshop style discussions over five days in summer 2023.
- A current and future state was mapped and a gap analysis was completed. Solutions were identified, prioritised and implemented over a ninety day period.'
- Progress updates were reported to all participants and stakeholders at RIE thirty, sixty and ninety days.
- The process was facilitated by the Ireland East Hospital Group Improvement Team.
Results: The following were identified as priority areas for development and change in practice;
1.Development and adoption of defined inclusion criteria, triaging and prioritisation systems and dissemination of same to all referrers. This facilitated more timely access for patients most in need. (ICPOP team were are able to see patients identified at high risk of hospital admission in a more timely fashion, without any change in resources).
2.Development, evaluation and re-evaluation of defined metrics to measure impact of service interaction on older persons’ quality of life and function.
3.Development of a service directory for older persons and establish clear integration pathways across acute and community services.
4.The development and provision of education modules on older person services and frailty identification for health and social care providers.
Conclusions: This process proved pivotal in the development of services provided for older persons in Carlow and Kilkenny. Referral rates and efficiency of access to the ICPOP service have increased significantly since the RIE.