The functionality and the quality of the geriatric service chain / Jaakko Valvanne and Esa Jämsen
Health and social care provided for the aged consist of a wide range of different types of services ranging from geriatric prevention to acute care and again to end-of-life care. Furthermore, it involves health and social care professionals at various levels from home care nurses and nursing home staff to paramedics, emergency medical services, ED nurses and physicians in primary and tertiary care units. Unfortunately, service chains are often considered complex both by professional and older patients and their families. Maintaining and improving health and function, however, would require services that are reachable, meaningful and effective. In particular, prompt and high-quality care is important in acute care of the aged in order to advance their recovery and to ensure continued living at home.
Successful management of older people’s health conditions should base on comprehensive assessment of their situation. This is important as common geriatric syndromes, like memory disorders and frailty, often remain unnoticed in routine care. This far, the benefits of care based on comprehensive geriatric assessment have been demonstrated among acutely ill older people and hip fracture patients. Unfortunately, such care is currently rarely available and there are difficulties in recognizing patients who should be admitted to geriatric units.
The purpose of this research project is to assess function, effectiveness and quality of geriatric services both from the viewpoints of the patient and healthcare system. Currently, the main emphasis is in detection of factors that predict different health outcomes and testing and developing tools for healthcare professionals for assessing older patients and monitoring quality of their care. In wide scale, the project covers preventive services, outpatient geriatric assessment, home care, emergency and hospital care, and long-term care. However, at the moment the main focus is on acute care of the aged and – on the other hand – on the management home care clients chronic conditions. From methodological point of view, the main interest is in the use of routinely collected and register-based data, like hospital discharge records and RAI assessments.
Besides coworkers at GEREC, the research group co-operates with researchers from Tampere University Hospital (emergency care, infectious diseases) and Finnish Institute for Health and Welfare.
Funding
State research funding. Tampere physicians’ society
Research group
Principal investigator
Esa Jämsen, professor of geriatrics (acting), esa.jamsen[at]uta.fi, Faculty of Medicine and Life Sciences, University of Tampere
Jaakko Valvanne, professor (emeritus), jaakko.valvanne[at]uta.fi, Faculty of Medicine and Life Sciences, University of Tampere
Postdoctoral researchers
Lauri Seinelä, MD, PhD, lauri.seinela[at]uta.fi, Faculty of Medicine and Life Sciences, University of Tampere
Heini Huhtala, University Lecturer, heini.huhtala[at]uta.fi, School of Health Sciences, University of Tampere
Doctoral students
Saila Haapasalmi, saila.haapasalmi[at]pshp.fi, Hospital care and and hospital readmissions in the aged
Hanna Kerminen, hanna.kerminen[at]uta.fi, Use of comprehensive geriatric assessment in clinical practice
Heidi Mörttinen-Vallius, Use of opioid analgesics among home care clients
Jukka Rönneikkö, jukka.ronneikko[at]uta.fi, RAI assessment in home care
Selected publications
Original article, Finnish Medical Journal, 2018: Screening of memory and attention disorders in hospital (Muistitoimintojen ja tarkkaavaisuuden häiriöiden seulonta sairaalassa).
Original article, Journal of American Geriatrics Society, 2017: Predictors for Unplanned Hospitalization of New Home Care Clients
Original article, Finnish Medical Journal, 2016: Urinary tract infections in acutely hospitalized geriatric patients (Virtsatieinfektio iäkkään potilaan sairaalaan oton syynä: onko diagnoosille perusteita?)
Review, Finnish Medical Journal 2015: When the disease is cured but the patient is not – Hospitalization-associated disability (Kun tauti paranee mutta potilas ei – sairaalahoitoon liittyvä toimintakyvyn heikentyminen).
Editorial, Finnish Medical Journal, 2012: Riskivanhukset tulisi tunnistaa paremmin
Editorial, Finnish Medical Journal, 2011: Hoitoketjut toimiviksi potilaan ketjuiksi
Collaborators
School of Health Sciences, University of Tampere (Marja Jylhä and research group of gerontology)
Tampere University of Applied Sciences (Taru Lehtimäki, Tuija Rasku, Sirpa Salin)
Tampere University Hospital (Sanna Hoppu, Satu-Liisa Pauniaho, Jaana Syrjänen, Mika Ukkonen)
National Institute for Health and Welfare (THL), Health and Social Services, Aging and Services (Harriet Finne-Soveri, Matti Mäkelä), and Centre for Health and Social Economics CHESS (Unto Häkkinen, Mikko Peltola)