Proposed Topic (Most preferred): :
Enhancing Partnership with Patients and Community (Projects initiated to engage patients / carers / community to improve efficiency / quality of care)
Authors (including presenting author) :
Fok YHD, Chung MK, Liu TH
Affiliation :
Department of Psychiatry, Kowloon Hospital
Introduction :
Our adult acute ward has encountered a notable prevalence of cases where patients with intellectual disability necessitate prolonged hospitalization. The program adopts an interactive model by a two-way process with an active exchange of information and mutual collaboration. It can be referred to the design of the care delivery and discharge planning for clients with intellectual disability. Hospital nurses and community carers act as both sender and receiver in the communication for collaboration. They partner closely and share useful information about the clients so as to formulate effective care plans and discharge plans. The "E-I-E-I-O" methodology is a comprehensive approach designed to address the specific needs of caregivers and clients with Intellectual Disability (ID) in the informal male psychiatric acute ward.
Objectives :
(1) To develop an interactive care model for clients with intellectual disability (2) To monitor the outcome of the interactive care model by the clients’ length of hospital stay (3) To evaluate the effectiveness of the interactive care model by questionnaire survey
Methodology :
EIEIO consists of five elements named “Engagement, Information, Education, Integration and Ongoing Support”. 1/. Engagement (E) Caregiver Orientation Session: A caregiver orientation session is held within 3 days of the client’s transfer/admission so as to establish a sense of partnership and collaboration from the outset. Initial interactive contact with caregivers is to achieve mutual understanding about the caregiver’s current knowledge /skills /caring situation and the ward environment /routine /clinical situation. Personalized engagement plan: A tailored-made plan is developed for each caregiver with regular follow-up and updates. 2/. Information (I) Customized patient care formulation sheet with real-time updates: A tailored-made patient care information sheet is provided to each caregiver about the client’s daily activities and behavioral strategies. 3/. Education (E) Specific training sessions: Useful educational information about effective care for the client is selected to caregivers. 4/. Integration (I) During hospitalization, those effective care approaches and strategies are integrated and passed to caregivers for continuity of care for the client. 5/. Ongoing Support (O) Support and resource line: Post-discharge telephone follow-ups within 3 days, and weekly check-ins for the first month are provided.
The baseline median length of hospital stay and the median length of hospital stay under the interactive care model were collected and analysed as outcome measurement. A questionnaire survey was designed to collect the opinions and feedback from both the perspectives of ward nurses and community carers for evaluation of the effectiveness of the program.
Result & Outcome :
The interactive care model was implemented from July 2023 to December 2023. In total, 40 clients with ID were discharged. The overall median length of hospital stay was reduced by 30.5% from 58.25 days to 40.5 days compared with the baseline. During the period, ward nurses and all carers of discharged clients with ID were invited to respond to the questionnaire survey. A total of 45 carer respondents and 20 ward nurse respondents were involved. All carers and nurses agreed that the interactive approach can facilitate mutual understanding between ward nurses and caregivers in caring for clients and promote the quality of care. Specifically, carers could be empowered with the consolidated effective caring skills for caring clients at home /in hostel. Nurses could formulate care for clients with improved effectiveness. Overall, 100% of respondents (Carers: 66.7% strongly agree and 33.3% agree; Nurses: 50% strongly agree and 50% agree) concluded that the interactive care model was effective. It is effective in promoting the quality of care, giving support to carers, achieving the desirable outcomes, and reducing the length of hospital stay.
