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How To Make Nursing Home Care More Efficient and Effective
The number of older people in need of nursing home care is increasing around the world, but the number of accessible medical experts is decreasing, with a global shortfall of 17 million health workers looming.
Making a diagnosis typically necessitates transfers to GP practices or even hospitals for some of the most basic diagnostic check-ups, which presents a big issue for nursing home management and personnel. This adds to the workload of the nursing home personnel, as well as the time it takes to get to the diagnostic institution and the cost of the transfer. Limited diagnostic equipment at nursing homes and a physical distance from the resident’s GP, who is always external, are at the basis of the problem.
This article explores technological solutions for taking basic diagnostic measurements in the nursing home and sharing them with the GP or hospital immediately. This translates to fewer labor for the staff, lower costs, and quicker diagnosis. As a result, patients receive more effective nursing home care and have a higher quality of life. Hospitalizations are a major source of stress for residents and their families, and they should be avoided if at all possible.
What are the diagnostic challenges in nursing homes?
Fragmented diagnostics, i.e. diagnostics performed in many sites, often for the most basic parameters, is the biggest diagnostic difficulty in nursing homes today. The clock starts to tick when there is an ambiguous clinical scenario with a nursing home resident for two reasons. To begin with, it is quite unlikely that a doctor will be available at that time. Second, even if one exists, even the most basic diagnostic tools are often unavailable. As a result, diagnostic hospitalizations are relatively common.
Why are unnecessary hospitalisations a problem?
Nursing home residents are one of the most vulnerable populations in society. Even when not in this type of care, the elderly are threatened by infections because their immune system is generally weaker. Age-related changes in adaptive and innate immunity may also result in reduced responsiveness to vaccinations, systemic pathogen infections (e.g. with Listeria) and reactivated lated infections (e.g. Mycobacteria, varicella zoster virus). Furthermore, frequent antibiotic treatments can lead to infections with antibiotic-resistant pathogens.
Due to dementia, immobility, incontinence and commorbidities (e.g. soft tissue or pulmonary edema), nursing home residents are at high risk of infectious diseases. The most frequent are pneumonias, infections of the urinary tract, gastroenteritis and skin infections.
The first consequence in case of unnecessary hospitalisation is stress caused to the resident and their relatives. Secondly, “nursing home residents can serve as unintentional vectors that shuttle clinically relevant pathogens from the nursing home to the hospital, and back to the nursing home, and impact on the infectious disease burden of an entire community”.
It is more sensible and safer to make an initial diagnosis by performing the basis diagnostic measurements on-site and immediately sharing them with the GP or hospital in digital form.
The financial perspective
Although a short hospitalisation of a resident does not always result in loss of income for the nursing home, unnecessary hospitalisations give rise to expenses for the health insurance company or for the resident in case of an excess insurance policy.
However, income loss for the nursing home can occur if the resident gets infected in hospital and requires hospital readmission for a longer time. More dangerously, a hospital-acquired infection can spread to other nursing home residents. This can result in more hospitalisations, with considerable financial consequences.
The organizational perspective
Fragmented diagnostics and unnecessary hospitalisations strain the already limited staff resources of all parties – nursing home carers, nurses, GPs and hospitals. They result in additional work like transport organisation, intense communication and a number of diagnostic check-ups at multiple locations. ‘Analog workflow’ like sending papers by fax and making multiple phonecalls for notifying their recipient is still a very important part of healthcare, and results in additonal time lost.
How can digital technology help with nursing home diagnostics?
Digital technology enables a number of effective diagnostic measurements without the doctor’s presence and immediate communication of their results to the distanced GP or hospital.
The MESI mTABLET combines ECG, blood pressure, oximetry, spirometry as well as ABI and TBI on one device. All the measurements are instantly saved into the patient’s electronic record and can be instantly forwarded either to their GP or a specialist.
The MESI mTABLET comprehensive diagnostic system has a number of advantages for the nursing home, its medical staff and its residents, both in terms of regular check-ups and effective diagnostic approach in sudden unclear health situations.
Regular check-ups
With the possibility of six diagnostic measurements on the nursing home premises, the residents’ health status can be monitored on a regular basis as no transfers to the GP are needed. The elderly are a risk group for PAD, especially when diabetic; the MESI mTABLET enables one-minute ABI or TBI screenings on-location.
In addition to the six basic diagnostic measurements stated above, the MESI mTABLET also enables the storing of other patient information (e.g. temperature, weight and general health status). Its users (GPs, nurses or other health professionals depending on the country) can create customised patient examination protocols in the Protocol App, which guides them through every step of the patient exam and interview. This enables the same level of care for each resident even if the staff changes. Taking pictures of wounds and other skin conditions is also possible with the Photo App. All information and measurements are stored in one place – the patient’s digital file, and can be instantly retrieved for comparison when there is a sudden health deterioration or condition.
Comprehensive diagnostic check in case of unclear health situation
The MESI mTABLET fits into a carry-on bag or on a trolley, which means that no special diagnostic room is necessary as it can easily be transported into a patient’s room in case of emergency.
Whether the GP is on the nursing home premises or makes visits when a health deterioration occurs, they can instantly receive the measurement results from the nurse and review them. The measurement results are anonymised, so they can also be sent to a specialist or hospital. In this way, a well-informed decision can be made as to the next step in the diagnostic and treatment process.
How can digital technology enhance the quality of life of nursing home residents?
Until the 20th century, infections were the most frequent reason of mortality. With the development of antibiotics, vaccinations, antiseptic techniques and other health measures, this is no longer the case in developed nations. The leading causes of mortality are now chronic and degenerative conditions. However, due to multiple comorbidities, many elderly people experience functional decline and dependency leading to nursing home care. This makes any infections highly risky, and preventing unnecessary hospitalisations is one of the ways to avoid them.
The MESI mTABLET has great potential in supporting nursing homes and GPs in their mission to care for the residents, both in terms of providing regular check-ups and comprehensive diagnostics in case of sudden health deterioration. For GPs, this makes it easier to decide whether hospitalisation or an emergency GP visit is necessary. This reduces the stress of the residents and their families, and enhances the life quality of those in nursing home care.
Less fragmented diagnostic services are not only more effective but also cheaper. Digital technology enables fast information sharing and thus faster cooperation between healthcare providers. Innovations will be decisive in the future of the nursing home sector, especially due to fewer resources, and will drive the development towards the highest possible quality of care. The MESI mTABLET aims to be a valuable tool in this field.
https://hiberniamedical.ie/shop/nursing-home-special-offers/caring-essentials/pulse-oximeters-caring-essentials/mesi-mtablet-system/
Contact us today to book a demonstration: 01 866 5727.
Article by MESI, February 14, 2022.
