Using Comprehensive Geriatric Assessment in Identifying Care Goals and Referral Services in a Frailty Intervention Clinic.

The proportion of older adults and frail adults in Canada is expected to rise significantly in upcoming years. Currently, a considerable number of older adults do not actively participate in developing their own care plans; prior research has indicated several benefits of patient engagement in this process. Thus, we conducted a mixed methods study that examined the prevalence of rehabilitation goals and identified these for 305 community dwelling older adults referred to a frailty intervention clinic utilizing Comprehensive Geriatric Assessment (CGA) between 2014 and 2018.

Growing pains: Lessons learned from a failed mobile mindfulness clinical trial for patients with complex care needs.

This paper discusses lessons learned from a failed clinical trial investigating the use of a mobile application (app) to deliver a mindfulness intervention to middle-aged and older adults receiving services at a rehabilitation hospital in Ontario, Canada. A randomized controlled trial with 82 participants was planned, with the experimental group receiving access to a mindfulness app and a wait-list control group receiving access to the app after 4 weeks; however, the study could not be completed due to low recruitment rates. This implementation failure was considered from the perspective of the PARIHS framework.

Creating and sustaining value: building a culture of continuous improvement.

In 2011, the Toronto East General Hospital (TEGH) began its journey towards developing a culture of continuous improvement. TEGH evolved to an organization-wide improvement system through a commitment to fiscal responsibility, practical innovation, team-based performance management, and daily management systems. This culture enabled the TEGH to achieve the lowest Emergency Department wait times for admitted patients in its local health integration network and reduce length of stay for patients with chronic obstructive pulmonary disease by 46%.