| Hospital A - prevention and reactivation care program | Hospital B | Hospital C |
---|---|---|---|
Hospital care | Identification of vulnerable older patient within 48Â h | Start reactivation treatment after discharge | Start reactivation path after discharge |
Assessment of risk factors for functional decline | |||
Start reactivation treatment within 48Â h | Medication safety project | Medication safety project | |
Clinical geriatrician | Clinical geriatrician (consultation two days a week) | ||
Geriatric nurses | |||
Electronic patient record including targeted consultation (consult dietitian based on SNAQ scores) | |||
Central intake prior to admission including screening frail elderly and development individualized care plan | |||
Multidisciplinary approach | Weekly multidisciplinary team meeting | Key professional is responsible for treatment and interdisciplinary consults | Key professional is responsible for treatment and interdisciplinary consults |
Treatment and care focused on medical condition | |||
and functioning in six domains (i.e. physical, mental, social, financial, home, and care) | |||
Discussion and coordination focused on medical condition | Discussion and coordination focused on medical condition | ||
Goal-orientated approach | |||
Patient | Patient orientated integrated treatment plan | Separate treatment plans | Separate treatment plans |
Discussion treatment with patient during entire treatment path | Treatment coherence determined by patient | Treatment coherence determined by patient | |
 | Problem solving |  |  |