Program enhancing quality of life for long-term care residents
A comprehensive diabetes program launched by OMNI Health Care in 2013 to enhance quality diabetes care for nursing-home residents across Ontario has earned recognition from the Ontario Long Term Care Association (OLTCA).
OMNI was awarded the Innovation of the Year award for the program during the OLTCA’s June 5 Quality Innovation Forum in Toronto.
At the centre of the program is a group of evidence-based order sets addressing several aspects of diabetes care, including nursing assessment, dietary and foot care, and sick-day management. The assessments can be used when residents enter long-term care homes as part of the admissions process.
Diabetes is a serious issue in long-term care, and its impact on quality of life is profound: fluctuating blood sugar brought on by diabetes can cause falls and the disease also poses challenges for wound care. Diabetes can also lead to cardiovascular disease and stroke.
By having better control of diabetes, residents can avoid hospital visits, which in turn improves quality of life while helping reduce the burden on the acute-care system.
The protocols developed are also designed to save time.
For example, a hypoglycemic event can take more than two hours to correct. If a hypoglycemic event happens when there’s a staff shortage, it compounds the stress level and can prolong treatment. But with the protocols, team members can quickly assess the situation and resolve it in a timely manner.
In the case of a hypoglycemic event, this can have tremendous impact on the person. Research indicates elderly people often have heart attacks or strokes within eight weeks of a hypoglycemic event due to its impact on the body.
By responding quickly or even eliminating the risk, there’s a large-scale trickle-down effect, says Shawn Riel, OMNI’s chief operating officer.
“The more events that we can eliminate, the better quality of life residents will have, and the lower health-care costs will be,” she says.
OMNI received a grant from Boehringer Ingelheim (Canada) Ltd. and Eli Lilly (Canada) Inc. in February 2013 to help make the strategy possible.
Assessments were done in each of OMNI’s 18 long-term care homes in areas including hypoglycemic events, numbers of residents with diabetes, and the time required to resolve issues related to diabetes.
A collaborative effort between registered staff members and community partners, including hospitals, clinicians and dietitians, made the order set a reality.
Medications were also assessed to find the pharmaceuticals that work best with the over-65 population. Every quarter a review is conducted to determine the success of interdisciplinary interventions on residents.
As part of the program, new protocols and strategies, including medications, were initially piloted at two OMNI homes, Riverview Manor in Peterborough and Pleasant Meadow Manor in Norwood. The program was then rolled out to OMNI’s other 16 long-term care homes.
One of the initiative’s greatest successes is that long-term care homes from outside the OMNI family are starting their own comprehensive diabetes programs focused on replicating OMNI’s successes, explains Riel.
“We’re hoping to help as many residents who live with diabetes in long-term care as possible to get more thorough assessments and receive better interventions to help them live a quality life,” Riel says.
OMNI president and CEO Patrick McCarthy emphasizes the efforts that went into developing this program.
“There were hundreds and hundreds of hours of work, reaching out to engage the physicians locally and to work with registered staff and administration at the homes to make sure that we got it right and to listen to any constructive feedback that we were able to get,” he says.
“We were able to get the documentation of statistics to help support the need for change and to really make it work from that perspective.”
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