Case-finding for disabilities with PRISMA-7 in emergency rooms: evolution in Sherbrooke, Québec
International Journal of Integrated Care, 31 December 2009 - ISSN 1568-4156
Poster abstract
Case-finding for disabilities with PRISMA-7 in emergency rooms: evolution in Sherbrooke, Québec
Michel Raîche, Research Centre on Aging, Sherbrooke University Geriatric Institute, Sherbrooke, QC, Canada
Réjean Hébert, Research Centre on Aging, Sherbrooke University Geriatric Institute, Sherbrooke, QC, Canada; Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
Marie-France Dubois, Research Centre on Aging, Sherbrooke University Geriatric Institute, Sherbrooke, QC, Canada; Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
Maryse Grégoire, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
Céline Bureau, Health and Social Services Centre—Sherbrooke University Geriatric Institute, Sherbrooke, QC, Canada
Correspondence to: Michel Raîche, E-mail: Michel.Raiche@USherbrooke.ca
Abstract


Introduction: The PRISMA-7 tool [1] has been introduced in two emergency rooms (ERs) in Sherbrooke to identify older people with significant disabilities. The seven yes/no questions had been included in the triage instrument for people aged 75 years and over. The positive cases were directed to the single entry point of the local health and social services centre, which then conducted assessment and eventually provided home care. The study's objective was to monitor the rate of PRISMA-7 use in ERs since its implementation (4 years ago).


Results: During the first year of implementation, the rate of PRISMA-7 use gradually increased up to 50–60%, then remained stable during the second and third years. This plateau can be accounted for, in part, by the scarcity of resources for assessing and delivering home-care services. The rate of PRISMA-7 use fell to 40% during the fourth year, which coincided with renovation of an ER. A 50% objective is in place.


Discussion: The rate of case-finding appears logical with the services actually available for assessing functional autonomy and the corresponding home services required. In terms of the population-health approach for supporting functional autonomy, it highlights the challenges in reaching the population level. As suggested by Young and Turnock [2], some managers consider publishing community-care waiting lists to increase attention and, consequently, priority in the health system.

Keywords
implementation of case-finding; disability; older people; emergency room
References
1.
Raîche M, Hébert R, Dubois M-F. PRISMA-7: a case-finding tool to identify older adults with moderate to severe disabilities. Archives of Gerontology and Geriatrics 2008; 47(1):9-18.
2.
Young J, Turnock S. Community care waiting lists and older people. British Medical Journal 2001 3; 322(7281):254.