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O3‐07‐03: Improving the system of care for older adults with dementia: Building capacity at the primary care level
Author(s) -
Lee Linda,
Hillier Loretta,
Heckman George,
Gag Micheline
Publication year - 2012
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2012.05.1179
Subject(s) - referral , dementia , audit , medicine , family medicine , memory clinic , primary care , nursing , disease , management , pathology , economics
ordination of services. These processes should be focused on primary care with timely support from specialized services. Even before the official launch of the plan, several Family medicine groups (FMGs) have developed and implemented some new clinical and organizational approaches. Methods: To support the Quebec’s Minister in developing a strategy for implementing the plan, a qualitative study was conducted among 11 FMGs in 2011 (24 semi-structured interviews). Study objectives were: -To identify the key components of the new approaches implemented in FMGs -To highlight their perceived impacts -To analyze barriers and facilitating conditions to their implementation.Results: FMGs are now responsible for detection, diagnosis, treatment and follow-up. Partnerships are established between physician and nurse teams with patients and their families. There are innovative features with regards to the primary-secondary care interface such as visiting specialists for patients with atypical cognitive disorders. In addition, FMGs coordinate care with other facets of the healthcare system: community-based health and social organizations (eg. home-based care); the community (eg. Alzheimer Society) and hospitalization units (care transitions). Clinicians working in FMGs or in specialist clinics expressed satisfaction and perceived positive impacts with regards to clinical practice and care for patients with Alzheimer’s and their caregivers. Various factors were linked with successful implementation: involvement of a champion (a family physician), logistical support from a change agent (from pharmaceutical company), and connectivity with specialists. Conclusions: Innovative clinical and organizational approaches in primary care are feasible and lead to promising results.