Dr Judy Lowthian is the Principal Research Fellow at the Bolton Clarke Research Institute, formerly known as RSL Care + Royal District Nursing Service Research Institute. She also holds an appointment at the School of Public Health and Preventive Medicine at Monash University and an honorary appointment with Alfred Health.
Her research is underpinned by an allied health background and her specific interest is health services research designed to improve the quality and safety of care for older people. In the past five years, Judy has been the recipient of $2.6M in competitive grants and prizes/awards. She serves on national and international committees that focus on improving geriatric emergency care.
Moving towards integrated emergency care for older people: Consensus Statement
Management of older patients at times of acute illness or injury does not occur in isolation in emergency departments, rather requires a systems approach, including: primary, pre-hospital, community, allied health, aged care and rehabilitation providers, emergency and hospital clinicians, family and other informal caregivers. Quality is often compromised by fragmented care and poor communication between providers, resulting in healthcare delivery that is ineffective, inefficient or inconsistent with patient preferences/goals. We aimed to develop a collaborative Consensus Statement that would enunciate the principles of integrated emergency care for older persons.
An evidence summary was developed and a Consensus Working Party convened with cross-specialty representation from multiple medical and allied health fields, including Professional Colleges, providers and administrators across the care continuum, government representatives, advocacy groups and consumers, to develop the content of the statement. A sub-committee produced a draft which was edited by the full working party.
Consensus was reached on content and ethos of the statement containing 12 principles and 6 recommendations for how to follow these principles, including an integrated care framework for action and what is needed to enact this
Priorities for action include working with older people, their carers, health and social care providers and managers to:
- Co-design care transitions and information transfer across the continuum
- Identify barriers and enablers to electronic health records, and develop strategies to increase uptake to ensure information sharing of information
- Promote active engagement in healthcare, then co-design strategies to support them to do this
- Improve community awareness of important issues in the care of older people, such as injury and falls/fracture prevention, availability of reablement services, after-hours health service access, respite care availability, advance care planning, end-of-life conversations and care
- Develop guidelines for healthcare environmental design that prevents deterioration in health and well-being and supports independence and specific care needs and the role of informal carers
- Develop core competencies, training/education for care providers; and develop strategies for implementation and evaluation of these principles of integrated emergency care.
The Consensus Statement was subsequently endorsed by 16 Professional Colleges, service providers and peak bodies.
Dissemination of the statement will encourage all stakeholders and associated policy bodies to review and embrace the principles and priorities for action, leading to establishment of collaborative work practices and improvement of care during and after acute illness or injury.