ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 142
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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Nursing home support team: Envisioning care in
nursing homes
Dr Grace Chiang1, Clement Chua, Kenneth Lam, Andrew Samson
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St Luke’s Hospital
Aim
The Nursing Home Support Team’s (NHST) project is a collaboration between SLH and various
nursing home (NH) providers to improve care within NHs so as to achieve and maintain an average
yearly reduction in the number of NH resident admissions to acute hospitals (AH) of at least 10%
measured from a baseline to minimise unnecessary readmissions to AHs and optimise care within the
NHs.
Content
Various initiatives (onsite medical coverage, telemedicine coverage, after-office-hours telemedicine
service, speech therapist (ST) services, transfer out (TO) reviews, training and education) were
implemented to avoid unnecessary and readmissions to the AHs. NHST has successfully reduced the
admissions to AHs by an average of 17.0%.
Goals
This project highlighted the importance of customised delivery of care. The uniqueness of each NH
required that NHST care delivery be tailored to suit specific needs and work cultures. Across the
three partners, there were preferential care delivery approaches to the residents. NHST doctor and
ST administered their interventions in view of the NH’s practices and model of care. The project
also emphasised the importance of goals of care discussions. CPs and PPCs are conversations
that featured strongly in many NH interactions. However, family members and caregivers were
uncomfortable and unwilling to talk about end-of-life discussions concerning the residents. In order to
overcome this challenge, perspective and understanding of ageing in the long-term care setting within
Singapore’s healthcare need to be changed to better support successful ageing in the long-term care
setting as well as promote quality of life for individuals in their end-of-life phase. Potentially, this may
attract more people to join the long-term care workforce, remove the stigma of ACP, PPC and end-oflife, and secure a healthy understanding of ageing in Singapore.
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