How a Tertiary Hospital Implement the

Principles of Age-Friendly Health Care

Ming-Yueh Chou, MD

Geriatric Medicine Center, Kaohsiung Veterans General Hospital, Taiwan

Health care of older people in Taiwan

People aged 50 and over used

- 42.8% of outpatient visits

- 52.5% of hospitalizations

People aged 65 or over

- >95% used outpatient services

- Annual outpatient visit: 27 visits

National Health Insurance in 2007

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Taiwan’s Framework of

Age-friendly Hospital

the WHO age-friendly principles

the WHO HPH model

the Vancouver Island Health Authority’s Elder-Friendly

Hospital Initiative

It consists of vision, values, missions,

and strategies on four dimensions

- management and policy

- communication and services

- processes of care

- physical environment

Kaohsiung Veterans General Hospital

A tertiary medical center

1389 beds

Outpatient: 108,000 visits per month

65-y/o : 38.8%

ED: 7159 visits per month

65-y/o : 27.2%

Inpatient: 3375 per months

65-y/o : 42.6%

Established in 2004

Core Value：

- Integrated Services、Team Work、Respect Life

Mission：

– Provide Good Quality Care

for Older Persons

– Develop a Good Team Work

– Be an Excellent Training Center

for Geriatric Medicine

Geriatric Medicine Center

Taiwan’s Framework of

Age-friendly Hospital

Strategy 1： Management policy

1.1 Developing an age-friendly policy

1.2 Organizational support

1.3 Continuous monitoring and improvement

Promote Geriatric

Medicine

Value the care for older

persons

Build up Geriatric

Medicine Building

Drive policy of

geriatric medicine

Expend Geriatric

Medicine

Age-Friendly Environment

Our Management Policy

Taiwan’s Framework of

Age-friendly Hospital

Strategy 2：Communication and services

2.1 Communication

2.2 Services

All healthcare professionals,

hospital staff and volunteers

Continuing Education Programs

• More than 60 hours per year

• Including age-friendly principle, health promotion,

integrated services, gender, and so on.

• Should attend at least 2 hours per year

• Free for all healthcare staff outside our hospital

Continuing Education Programs

Doctors Nurses health care staff Volunteers

To empathy older people

Older Persons Simulation

Experience

Taiwan’s Framework of

Age-friendly Hospital

Strategy 3： Care processes

3.1 Patient assessment

3.2 Intervention and management

3.3 Community partnership and continuity of care

To solve the problems

of frequent ED visits

and unnecessary stay

To cooperate with ED

CGA in the ED

Project in the Emergency Department

Parking Area

Volunteers Reception for frail older persons

Special area for frail

passengers

Age-friendly Outpatient Service

Help to leave or go to cars

Convenient

administrative

processes Comfortable

Waiting Area

Readable signage

Integrated

Electric System

Age-friendly Outpatient Service

Fall

Clinics

(CGA)

Integrated Outpatient Services

Sheets for

Summary of All

Medications

Medication

consultation

Medication review

by IC cards

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Medication review

before admissions

Pharmaceutical Care

in the Older Persons

Drug boxes, Big Stickers

Pharmaceutical and Nutritional Care

Blood Drawing Area Radiological

Examinations

good lighting, non-slip floor surfaces,

stable furniture and clear walkways

Area for

Wheelchair

Age-friendly Examination Area

Walker Wheelchair hand railings

Award for the Best

Age-Friendly Environment, 2012

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Alarm System for Patients with

Dementia

Area 1

Area 2

Toilet

Alarm signal with music

Clock and Calendar Light Therapy

Good Lighting in daytime

Well Orientation to Avoid

Complications

Onsite Rehabilitation Area

Bladder

sonography

Accessible Toilet

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Hearing Aid

Glasses

Writing Board

Pictures

Reception of Nursing Station

Big Room Number

Devices for Communications

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Comprehensive Assessment for

Inpatients Nursing Assessment

基本資料

個人病史

日常生活

營養評估

身體評估

心理評估

環 境

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Multidisciplinary Team works

Records of MDT

meeting

MDT meeting every

week

30

Doctors

Discharge Plan

Nurses

Discharge education

Intermediate Care for

disable patients

Discharge Plan and Intermediate Care

Community Services

Taiwan’s Framework of

Age-friendly Hospital

Strategy 4： Physical environment

4.1 the common principles of Universal Design

4.2 transportation

4.3 Simple and easily readable signage

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Common Principles of Universal Design

Project from Ministry of Health and Welfare, 2013

Help 15 hospitals to

provide integrated care for

older persons

• Age-Friendly Hospitals

• Integrated Outpatient

Services

• Team Care

Guidance for Integrated Care

Services for Older Persons

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Qualified as Age-Friendly Hospitals

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Thank You !