Baycrest

Program Evaluation Unit (PEU) Project Highlights practices. Under the guidance of Anna Berall, the PEU oversaw all aspects of the study including study design, and training and implementation of the tool to three units. The PEU collaborated with the Advanced Practice Nurses for the study. The PEU developed the database, collected data, surveyed nurses, analyzed the data, wrote a study abstract, and completed a poster presentation for the Baycrest Poster Day, the Annual Ontario Gerontology Association OGA/RGP Conference 2014, and at the Gerontological Society of America Annual Conference 2014. The CAM study integrated delirium screening into clinical practice and provided a platform for dissemination to other units. This study facilitated Baycrest's designation as a Best Practice Spotlight Organization from the Registered Nurses' Association of Ontario (RNAO). Since December 2010, the PEU team has supported evaluation projects spanning years of work with resounding success. The following are some highlights: EVALUATION OF TRAINING & IMPLEMENTATION OF THE CONFUSION ASSESSMENT MODEL (CAM) Lily-Beth Jones, Deb Sewell, Anna Berall (2012-2014) Delirium is associated with poor outcomes such as prolonged hospitalization and functional decline. This study evaluated the training and utilization of the Confusion Assessment Method (CAM) tool by nurses on the Baycrest rehab and acute care units. A three-phase training program for the CAM was introduced. The PEU surveyed nurses after the training and after implementation of the CAM. The PEU conducted a retrospective chart review to determine rates of compliance. The PEU initiated support for the study to standardize data collection and to introduce best FOLLOW-UP OF THE SLOW STREAM REHABILITATION (SSR): PREDICTOR OF OUTCOMES 4 MONTHS POST DISCHARGE Dr. Paul Katz, Dr. Gary Naglie, Dr. Jurgis Karuza, Angela Chan, Grace Leung, Anna Berall (2011-2014) This study was an AFP-funded project that addressed the need for knowledge in caring for the frailer, more medically complex population that characterizes the long duration, low intensity, slow stream rehabilitation program. It also defined the predictive validity of assessment tools by following a cohort of slow stream rehab patients and determining their status (death, rehospitalization, admission to a nursing home, community living) four months post discharge. The PEU wrote the study proposal, completed REB applications, and engaged the clinical team in the development of the methodology by selecting validated measures to create an outcomes measures tool kit. The PEU carried out data collection and oversaw volunteers who assisted with the project. The PEU recruited 105 patients, conducted patient interviews, trained clinical staff, and conducted inter- rater reliability testing for functional measures and completed data analysis, study abstracts, and conference posters. A manuscript has been accepted for publication in the Journal of the American Medical Directors Association. This study created an evaluation model for program evaluation studies at Baycrest. PEU-SSR Study Poster Presentations: 1. "Predictors of Outcomes in Low Intensity, Long Duration Rehabilitation". Annual Meeting of the American Geriatrics Society. 2014, Orlando, FL. 2. "Functional Gains and Discharge Destinations of Patients Admitted to a Geriatric Slow Stream Rehabilitation Unit". Ontario Long Term Care Applied Research Day. 2014, Toronto, ON. 3. "Functional Gains and Discharge Destinations of Patients Admitted to a Geriatric Slow Stream Rehabilitation Unit." Annual Ontario Gerontology Conference. 2014, Toronto, ON. 4. "Characteristics of Patients Admitted to a Slow Stream Rehabilitation Unit: Implementation of the Confusion Assessment Method on Three Geriatric Units". Annual Ontario Gerontology Conference. 2014, Toronto, ON. PEU-CAM STUDY ACHIEVEMENTS: Development of a training curriculum Implementation of a CAM screen in Meditech. An audit of 88 admission CAMs on three units 30 days post implementation of the tool revealed a compliance of 85.2%. Contribution to data collection methods for other program evaluation projects in describing patient characteristics for delirium Page 9 April 1, 2014- March 31, 2015 ● KLAERU-PE Annual Report

• Cover