Centre of excellence in medical care of the elderly.
Brisbane Waters Private Hospital in Woy Woy on the NSW Central Coast Australia is one of the first private hospitals to follow the principles and model of care from Dr Lipski’s “White Paper” and book “Your Elderly Parents Failing Health. Is It Ageing Or A Treatable Condition” on improving medical care for frail older patients.
These principles, which are outlined in the latest edition of Dr Lipski’s book, were introduced to take age out of the equation when it comes to clinical care at Brisbane Waters Private Hospital.
“By introducing a holistic approach which focuses on core pillars of care, we have been able to see our geriatric patients dramatically improve, recover and return home in greater numbers than previously experienced” says the CEO of Brisbane Waters Private Hospital.
“Through measures to improve and address malnutrition, blood pressure, adverse drug reactions, the introduction of extensive pre-op and post-op geriatric assessments, we have seen a dramatic transformation in our older patients” says the CEO.”
In addition to this, a project entitled HUNGER (Helping Under Nourished Get Energy to Recover) has been introduced at the hospital as part of a working group which focuses on empowering nutrition for recovery.
The project has been done in collaboration with occupational therapists, nursing staff, dietitians, Dr Lipski and physiotherapists to improve services, including the development of a screening tool which aims to identify potential malnutrition.
“No-one is ever too old for treatment. One of the reasons that geriatric medicine is so successful is because there is attention to detail, getting the simple things right and a holistic overview of the whole patient, not such a specific organ approach,” Dr Lipski said.
“By applying a holistic approach which tackles a reduction in drugs and adverse drug reactions, improving nutrition and mobility, managing low blood pressure, treating organ specific disease and chronic pain, you can achieve great outcomes for older patients”.
“By removing ageism and age from the clinical discussion and instead looking closer at patients to understand their symptoms and underlying illness, we have a greater chance of not only helping our patients but improving their overall quality of life so they recover, return home and continue to live a fulfilled and healthy life,” says the CEO.
Patients get a medical diagnosis and management plan within 24 hours of admission. Investigations and tests are done within 24 hours. Detailed information is obtained from families and carers on day 1. All medications reviewed for adverse drug reactions and drug interactions on day 1. Safe discharge plans start on day 1. Multi-disciplinary allied health team including physiotherapy for early mobility, dietician review of nutrition, speech pathology assessment of swallowing, occupational therapy assessment of pressure area risks, activities of daily living and cognitive assessments are all done early in the admission with an early focus on improving general function and mobility for safe discharge home and reducing length of hospital stay. Referring Doctors are sent a detailed comprehensive discharge summary highlighting the key medical issues, any ongoing concerns and follow-up arrangements.
Dr Lipski would like to see the introduction of merit awards A, B and C levels for private hospitals to reward better care by providing incentive payments to those private hospitals following holistic medicine principles from Dr Lipsk’s “White Paper”.
The NSW Health Department in 2008 came out to review Dr Lipski’s new model of holistic geriatric medical care and were very impressed.
The NSW Health Department in 2008 invited Dr Lipski to present his “White Paper” principles to the highest level health executives including the NSW Director General of Health who were all very impressed but nothing further was done!
All public and private hospitals must provide holistic general geriatric medical care and complex safe discharge planning for frail older patients.
The days are gone when hospitals rely on multiple single organ doctors (SODs) to see a complex frail older person with nobody taking control and sorting out the patient’s multiple medical problems. This approach is NOT cost effective and does NOT produce good health outcomes fof these older patients!
For more information read Dr Peter Lipski’s book “Your Elderly Parents Failing Health. Is It Ageing Or A Treatable Condition”.