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Geriatric Acute Wards

What is it

Geriatric Acute Wards provide dedicated acute care spaces for the older person and provide multidisciplinary team approaches to improve the management of the older patient by providing specialised aged care early to improve patient outcomes.

How it works

Patients are transferred to the acute ward generally from the Emergency Department, although in some locations, admission is available directly from either community teams or General Practitioners and confirmed by the admitting geriatrician.

On admission, patients will undergo an assessment by an aged health specialist (i.e. a geriatrician or aged health advanced trainee) who will work in collaboration with nurses and allied health to establish a management plan for the patient that involves the most appropriate care pathway or disposition for the patient. 

Principles of this model of care include:

  • shared care between physicians, geriatricians and their multidisciplinary teams
  • optimal medical and nursing care of patients through integrated geriatric assessment in an interdisciplinary environment
  • comprehensive holistic geriatric assessment beyond the presenting illness
  • the optimisation of care by focusing on promoting independence and function – that is, a nursing and care philosophy of enablement
  • early discharge planning, including timely referral to appropriate community services.

Resourcing

The model is staffed by a multidisciplinary team comprising of senior aged health decision-makers such as geriatricians/aged health advanced trainees, nurses (included Clinical Nurse Specialist, Clinical Nurse Consultant) and allied health staff (i.e. social workers, physiotherapists, occupational therapists, speech pathologist, dietitians, and pharmacists). 

Success factors

  • Establishing an early management plan
  • An enablement philosophy of care operationalised by a multidisciplinary team
  • Establishing a discharge plan on admission and working towards discharge from the point of admission
  • A process to facilitate a bypass of ED when transferring from primary/community care to an acute model.

Models in operation

  • ACE (Hornsby)
  • OPERA (Westmead)
  • MAU (Nepean)
  • Aged Health acute and rehabilitation wards (Sutherland, Concord)
  • Dedicated Stroke Services Ward Model (Wagga and Westmead)
  • AARCS