Fewer frail older patients in Canterbury are staying in hospital more than 10 days thanks to the development of the Canterbury District Health Board's (CDHB) Frail Older Person’s Pathway.

The documentation on HealthPathways is a small part of the whole pathway which consists of eight initiatives to improve care for frail older patients in areas such as medicine, surgery, and Older Persons Health and Rehabilitation (OPH&R).

HealthPathways Community Chief Clinical Editor Graham McGeoch says that the development of the pathway was a system-wide effort, with HealthPathways being one of many departments and initiatives working in sync to discover ways of improving care.

"HealthPathways is an important tool for developing these new ways of working," he says.

"Many of the people who have contributed to this pathway haven't had any involvement with us. However, HealthPathways has helped achieve agreements across the many areas of our health system that are involved with older people and documenting them for dissemination, feedback, and improvement.

"By doing this, relationships have improved and other iterative changes have been developed which may not require our involvement. But, conversely, as HealthPathways is the main place things like the Falls programme are documented, it pushes more people to look at our work."

The Frail Older Person’s Pathway includes initiatives for improving care in both Christchurch Hospital and the community service CREST (Community Rehabilitation Enablement Support Teams). These initiatives include:

• A pilot restorative care model in General Medicine aimed at better managing prolonged hospital stays.
• The introduction of electronic patient journey boards on some wards to improve visibility of expected days of discharge and clinical criteria for discharge.
• The use of assertive board rounds in OPH&R that improve the flow of information for interdiscplinary teams. This allows them to make daily decisions on patients' needs that lead to more responsive and appropriate discharges, and has also resulted in more efficient weekly meetings that now provide more time for in-depth discussion and complex problem-solving.
• The creation of a new Medical Registrar role in surgical wards to support elderly surgical inpatient management.

CDHB CEO David Meates recently hailed the success of the Frail Older Person’s Pathway as an important development for the district that has more elderly patients than any other in New Zealand.

"As our community continues to age, even small increases in the number of elderly people admitted into hospital can have a big impact."