Virtual Care Insights

Summary

This article explores the implementation of a virtual specialist consultation program for advanced frailty care during the COVID-19 pandemic. The program aimed to establish appropriate goals of care and align interventions with residents’ frailty and expected outcomes. Findings reveal both the advantages and challenges of such programs, offering valuable lessons for future implementation and sustainability.

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** Main Story**

Okay, so the COVID-19 pandemic really shook up healthcare, especially for those frail older adults in long-term care (LTC) facilities. I mean, figuring out the right goals of care (GoC) when everything was so chaotic? A real challenge. It’s no surprise then that a lot of healthcare systems started trying out new things, like virtual specialist consultations, to better look after this vulnerable group. And I think it’s worth delving into a study that looks at how one of these programs worked, what we learned from it, and where we can go next in geriatric care.

Digging into the Details: A Virtual Consultation Program

A recent study in the Canadian Geriatrics Journal examined this virtual specialist consultation program designed specifically for residents in LTC with advanced frailty. The main goal was simple: make sure the care they were getting matched their individual needs and what we realistically expected. The study was looking at how well it worked, what made it easy, and what got in the way. They talked to LTC leaders, healthcare staff, and the program team, really getting a broad picture. To analyze all the data they used the Consolidated Framework for Implementation Research (CFIR). I think that’s really important, you can’t just throw these programs together, you need the data to back it up.

What Did They Find?

Now, the results were a bit of a mixed bag. On the one hand, people said the care got better, and fewer people ended up in the hospital unnecessarily, that’s a real win, isn’t it? The program was prioritized and people involved knew there was shared frailty-informed care among the team, that really helped.

But on the other hand there were a lot of barriers. One thing they found? GoC approaches, they weren’t always on the same page, and there was a lot of information not being shared between LTC and hospitals. That’s never good, I’m sure you can agree. But, the hardest thing? Keeping the program going after the initial crisis. Once the pandemic slowed down, resources went back to normal care, and people just didn’t see the point of a specialized GoC service outside of a crisis. Which, in hindsight, isn’t too surprising, is it?

Key Takeaways for the Future

So, what can we learn from this? Well, this study really drives home the importance of teamwork and shared understanding, especially during a crisis. At the end of the day it also highlights how difficult it is to keep these cross-sectoral GoC services alive, especially when things go back to “normal” and old habits creep back in, and workloads shift.

For example, there was this one time when I was volunteering at a local clinic and the communication breakdown between the specialist and the GP was so bad, it almost led to a critical medication error. Luckily, it was caught in time, but it really highlighted the critical need for better interprofessional communication. The findings also suggest, that we need to show people the ongoing value of these programs, even when we aren’t in the middle of an emergency.

The Bigger Picture for Geriatric Care

Honestly, this all has bigger implications for geriatric care in general. Technology is getting better and better, and virtual care models have huge potential, you know? It could mean better access to specialists, better care coordination, and more personalized interventions for older adults. But, if we want to really make it work, we need to think carefully about how it fits into existing systems, how everyone communicates, and what patients and providers really need. And we have to be proactive about tackling these challenges.

Think about it: sustainable funding models, effective training programs, and long-term evaluation of the impact of these interventions on patients and the system. I think all of this is vital. I mean, as the population continues to age, these kinds of innovative models, like virtual specialist consultation programs, will be essential to make sure everyone gets high-quality, person-centered care. It’s not going to be easy, but it’s a challenge we can’t ignore, and frankly, I don’t want to imagine a world where we do.