The 14^th EuGMS (European Geriatric Medicine Society) congress took place October 11-12^th 2018 in Berlin. From Cross-Care Old, three PhD students from work package 1 (WP1), Linda Aimee Hartford Kvæl, Ingvild Lilleheie and Christine H. Hestevik, attended this inspiring congress, together with Maria Bjerk, a fellow PhD student from the Department of physiotherapy at OsloMet.

The congress theme was “Advancing Geriatric Medicine in a Modern World”, with a special focus on developments driven by technological and pharmaceutical innovations. In addition, new concepts that have evolved directly from the traditional principles of geriatric medicine were presented. The congress aimed to reflect the diversity and offer new ideas and insights for clinicians working with older patients in any continent of the world.

Linda had a poster presentation showing the results from her interviews with geriatric patients and their relatives in the context of intermediate care (IC) regarding patient participation. The title of the poster was “Choice, Voice and Co-production in Intermediate care: Exploring Geriatric Patients’ and their Relatives’ Perspectives of Patient Participation in Intermediate Care”. The analysis disclosed a lack of choice in a predetermined pathway. Being deserving means to be “sick enough” and was associated with the compliant patient that fits the system. Some main additional features are the need of a rehabilitation perspective and patient engagement to enable co-production as well as the important contribution of relatives as advocates and allies. Finally, the results show the patients vulnerable voice in the meeting with experts’ views. Although most of the patients benefited from IC, patient participation in this context could indeed be delivered in a more empowering way. Patient participation in IC seems to be influenced by underlying structures such as market, bureaucracy and psychology.

Christine presented a poster with results from her patient interviews, in addition to results from a study that investigated nutritional information in medical records/journals. The title of the poster was “Inadequate Nutritional Care and Nutritional Documentation in Medical Records of Older Patients”. The aim was to explore older patients’ experiences of nutritional care in hospital and after hospital discharge and to investigate documentation of nutritional information in medical records. The results presented here was lack of continuity of care, inadequate communication with and poor involvement of elderly patients in own nutritional health and care planning and inadequate documentation of nutritional information in the medical records.

Ingvild had an oral presentation where she presented her systematic review, Elderly patients’ experience of participation in the hospital discharge: A Qualitative Metasummary.  The aim of this systematic review was to integrate international findings of older patients’ experience of participation in their discharge process from hospital, and to explore the patients’ rights and opportunities to influence the decision-making process through dialogue attuned to their preferences and potential. The findings show that older patients experience little impact in the discharge process. Participation are not sufficiently embedded in the process, and the results demonstrate that there is a gap between published health policy regarding elderly patients’ participation and the professionals’ opportunities to fulfill this policy in clinical work.

The congress was truly inspiring and packed with interesting presentations. As PhD students it was useful to get a taste of what is happening within our fields. With respect to truly inspiring presentations, Ingvild and Christine agreed on that the cultural gerontologist Prof Desmond O’Neill was memorable. He is specialist in geriatric and stroke medicine, and a writer and commentator in national media. He is concerned with the ways we portray older people and emphasize that we should use sensitivity and precision in such portraying to prevent ageism. The focus in media makes us see only disability and frailty and we therefore lose sight of the core values of those we serve as well as the benefits of ageing. He emphasizes that older people should be described in ways that respects their complexity, contribution, and civic engagement.

We also had the chance to meet the Editors in chief from major geriatric journals such as “The Journal of Post-Acute and Long-Term Care Medicine”, “Journal of the American Geriatrics Society” and “Age & Ageing” at a workshop, providing us with powerful insights on how to “get ready for research and publication”.

We really enjoyed this trip. We arrived home, full of new inspiration for our projects. It was also nice to socialize with colleagues and get to know each other a little better. Berlin was warm and sunny, and in our free time, we (of course) did some shopping and ate at some very lovely restaurants.

Den 25 oktober 2015 ble paperet “Kluss i vekslinga? Hvordan opplever sykepleiere i sykehus at eldre pasienter blir ivaretatt i overgangen til kommunale pleie- og omsorgstjenester?” presentert på Den 6. nasjonale konferansen for omsorgsforskning, ved Quality Airport Hotel Gardermoen. Heidi Gautun, Ragnhild Hellesø og Henning Øien har i dette arbeidet analysert svar fra de 2431 sykepleierne som jobbet på sengeposter i somatiske sykehus i mai 2017.

Cross-care was visible at International Medical Informatics Associations – Nursing Informatics (IMIA NI) conference in Guadalajara, Mexico in June 2018 by providing one oral presentation and one panel presentation. The oral presentation build on a survey conducted among 2 431 Norwegian hospital nurses were we investigated how safe and effective e-messages were regarding discharge planning between hospital nurses and the municipal level of administration. Hellesø and Gautun’s proceeding submission received award quality by the reviewers. The paper is published here:
https://www.ncbi.nlm.nih.gov/pubmed/29857439

The panel presentation highlighted Digitalization of Patient Information Process from Hospital to Community Home Care Nurses: International Perspectives. More information about the panel is published here: https://www.ncbi.nlm.nih.gov/pubmed/29857442
How international conferences can contribute to connect and build sustainable research collaboration is described at IMIA NI’s website: http://imia-medinfo.org/wp/sig-ni-nursing-informatics/

30. april 2018 ble det arrangert et det statusmøte for Cross-Care Old på OsloMet. Alle tre arbeidspakker presenterte hvor langt de er kommet så langt i arbeidet med datainnsamling, analyse og publisering. Mye har skjedd siden sist møte, og flere artikler er publisert!

Vi diskuterte også mot slutten av møtet muligheten for å samle kunnskapen vi tilegner oss i løpet av prosjektet i et spesialnummer i et tidsskrift samt arrangere et et-dags seminar for relevante fagpersoner, politikere og andre interesserte.

In November and December 2017, a nationwide web- based survey was conducted among 5816 nurses working in nursing homes and home nursing (members of The Norwegian Nursing Organization). Altogether 88% of Norwegian municipalities were represented (378 of 429). The survey focused on local nurses’ experiences’s and perspectives from vertical coordination of discharging older patients from hospitals. The respondents’ answered several questions about their collaboration with hospitals in the critical phase when older patients were transferred to their workplace. A main purpose with this survey was to investigate whether there is a connection between amount and types of collaboration and how well older patients are taken care of in the transition from hospitals to local care services.

One of the PhD students in WP1, Cecilie Fromholt Olsen, has been working in the Cross-Care Old project since August 2017. The name of her project is “Learning networks to develop better patient pathways for older people in primary care- health professionals’ experiences”. This is a qualitative project with method triangulation of observation, focus group interviews and individual interviews with health professionals who are involved in learning networks for paient pathways. These learning networks are driven by the Norwegian Association of Local and regional Authorities. Eight learning networks will take place in different regions in Norway within the next two years with the aim og improving and making the patient pathways for older and chronically ill patients more user-friendly. Cecilie has recently started to follow one of these networks and her main interest seems to be the implementation of new ways of thinking and working in a more user-friendly manner in everyday practice from the perspective of health- workers. She is currently working on a qualitative meta-analysis concerning these topics.

The Norwegian project group arrange a meeting with international partners on 24th of August .

Programme

10-10.30: Welcome and presentation round

10.30-11: Overall presentation of Crosscare-Old

11-11:30: WP 1: User Perspectives on Quality in Transitional Health Care for Geriatric Patients

11.30-12.00: Discussion WP1

12-12.30: Lunch

12.30-13: WP 2: Vertical coordination of health and care services

13-13:30: Discussion WP2

13:30-13:45: Coffee break

13:45-14:15: WP 3: Horizontal coordination of health and care services (Ragnhild and Maren)

14:15-15:15: Discussion WP3

15:15-15:30: Break

15:30-16.15: WP4: Intro and discussion: Input and advice from advisory board members on transitional care model development

Programme 24th of August 2017  Oslo and Akershus University College of Applied Sciences

10-10.30: Welcome and presentation round (Professor  Astrid Bergland)
10.30-11: Overall presentation of Crosscare-Old ( Professor Astrid Bergland)
11-11:30: WP 1: User Perspectives on Quality in Transitional Health Care for Geriatric Patients (Associate professor Jonas Debesay and 3 PhD-students)
11.30-12.00: Discussion WP1 (all)
12-12.30: Lunch
12.30-13: WP 2: Vertical coordination of health and care services (Senior researcher Heidi Gautun)
13-13:30: Discussion WP2 (all)
13:30-13:45: Coffee break
13:45-14:15: WP 3: Horizontal coordination of health and care services (professor Ragnhild hellesø and Associate professor Maren Sogstad)
14:15-15:15: Discussion WP3 (all)
15:15-15:30: Break
15:30-16.15: WP4: Intro and discussion: Input and advice from advisory board members on transitional care model development