THE NEWSLETTER
May 2017
This month we highlight the ins and outs of senior friendly care in a new SFH Framework training video and in clinical care (feeding tubes and catheters). We also shine a spotlight on a growing global movement which gets patients out of pajamas and out of hospital sooner. 
NEW! The Senior Friendly Hospital Framework Video
Orienting clinical or quality improvement staff to senior friendly? This 7 minute video explores the background and purpose of the framework, provides an overview of the 5 domains, and presents practical applications of the framework in quality improvement work.

Click here for the SFH Framework Video
The Difficult Conversations and Decisions Around Feeding Tubes
Did you know that the  Canadian Malnutrition Task Force  provides a wealth of information on nutrition care, and also welcomes challenging questions from healthcare professionals, such as:

Is it appropriate to treat an alert 90-year-old patient, admitted from a retirement home, with enteral nutrition when she has been NPO for 3 days? She has a nasal gastric tube for medication administration. Click here for the response

Another great feeding tube resource
The Appropriate Use of Catheters
Health Quality Ontario recently highlighted that "Between 15% and 25% of patients will have an indwelling urinary catheter during their hospital stay, even though at least 50% of those catheter days are unnecessary and lead to patient harms, including infection,local trauma, and increased immobility."

How to get started - tools and inspiration 
Dr. Jerome Leis co-authored the  Lose the Tube Toolkit  after Sunnybrook Health Sciences' success in implementing medical directives to empower nurses to remove catheters. 

3 hospitals in the SFH collaborative created posters to highlight their quality improvement initiatives which focused on catheter reduction:   Pembroke Regional Hospital Royal Victoria Regional Health Centre , and  St. Joseph's Health Centre Toronto.

You will also find great resources on incontinence in the SFH Toolkit.
End PJ Paralysis
A fast-growing global social movement started by Professor Brian Dolan in the UK, called #EndPJparalysis, encourages clinicians to get patients up, dressed and moving. Professor Dolan explains that this isn't about project plans and gant charts, rather it's about enabling clinicians to do the right thing so that we give patients dignity, choice, and autonomy, and make it safer for them.

One hospital in the UK found that 3 months into their campaign to #EndPJparlaysis, they had decreased the LOS for frail elderly patients from 10 days to 5Read the article here

How to get started - inspiration
Find inspiration in the millions of tweets for #EndPJparalysis, such as this Cambridge University Hospital campaign (pictured above), and on Professor Dolan's website  The Last 1000 Days, a related call to action which encourages clinicians to think about "Making patients' time the most important currency in healthcare"

Don't forget to tag @RGPToronto and @BrianwDolan, and use #EndPJparalysis so we can continue to spread this movement.
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