“During the holidays, there are fewer families present and doctors available, there is always an influx of elderly people. But there, it is a little more substantial”. Marie Grand-Mangeot, nurse in advanced practice within the mobile geriatric liaison team of the CHRU of Nancy realizes this daily. Between 15 and 20 patients over the age of 75 come to the hospital every day. In already overwhelmed emergencies, they sometimes wait for hours, for a consultation that could have been done at home. To remedy this situation, a hospital/city regulation unit has been set up.
Connect the right partners
“The question arose, since the elderly are there anyway, how to ensure that they stay in the emergency room as little as possible, and that they are accompanied as well as possible?” explains the nurse. At the beginning of the week, and in just a few days, the cell was therefore set up. It is managed by the CHRU, and many actors are involved: the mobile team and the social service of the hospital, the Territorial Community of Health Professionals (CPTS) of the Nancy metropolis, the territorial support platform (PTA ) in Greater Nancy, and home hospitalization in the Nancy conurbation (HADAN).
This cell makes it possible in particular to limit the waiting time in the emergency room. “The CPTS has a watch of doctors available who can provide follow-up instead of the treating doctor for their holidays: if we want to send someone home quickly, but this person requires follow-up, the organization can put us in connection with liberal doctors who will be able to take care of it” describes Marie Grand-Mangeot. Conversely, the attending physician can ask the geriatric department for an opinion, and request hospitalization; the time a bed becomes free, city partners can go to the patient to assess himr, and check that there is indeed a need for hospitalization. They also help to count the means of the territory, to find, for example, places in EHPAD.
Make up for the lack of caregivers and hospital beds
If the cell was put in place so quickly, it is because the resources are just-in-time. On the one hand, with hospital vacancies and the difficulties in finding replacements, the CHRU cannot deploy staff just to make the journey of the elderly more fluid; on the other hand, the holidays of attending physicians and the lack of home help staff require compensation by the city partners.
This cell could be put on standby once the influx of patients over 75 has passed, and reactivated as needed.
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