Evaluation of the Enhanced Seniors Team Initiative

Primary Investigators: Katy Mukai and Dr. Ann Holyrood

The Enhanced Seniors Team (EST) is an initiative under the Care Continuum Transformation Project (CCT) that the Vancouver Island Health Authority (VIHA) launched at Nanaimo Regional General Hospital. The EST focuses on improving care for frail, at-risk older adults being seen in the Emergency Department (ED). The aim of the EST is to initiate early, goal-directed care planning and evidence-based interventions to prevent cognitive and functional losses associated with acute illness among hospitalized older patients. The team collaborates with the medical and surgical unit teams to achieve patient goals, decrease hospital length of stay and improve transition to home. The interdisciplinary EST includes a case manager who helps reduce unnecessary hospital admissions by providing referrals that increase access to community-based services and resources.

The health authority wishes to evaluate the impact of the EST in Nanaimo in order to inform implementation of the model in other VIHA hospitals.