About the Project
Adult and geriatric psychiatry patients, particularly those age 65-75, are falling through the cracks of community care in Victoria, resulting in more frequent utilization of the ER and longer lengths of stay in hospital. This was the hypothesis of a group of Adult and Geriatric Psychiatrists, led by Dr. Jeanine Marshall, who secured a second phase of funding to run a survey to better serve this patient population.
And yet when the group reconnected after 4 months to review the results of the survey, their results surprised them. It was not just specific gaps in community services driving sub-optimal care of patients, but rather broader systems issues that create silos in care that can end up excluding certain patients. They saw opportunities to advocate for patients by focusing on the specific needs of an individual patient. At times, this means asking that programs and services be flexible in their inclusion and exclusion criteria in order to help patients gain better access to the services they actually need. For instance, an adult patient might be better served by geriatric psychiatry, even if their age did not meet the strict cut off criteria, and vice versa. As a result, the overall focus of the discussion was on maintaining flexibility, and on making a strong, evidence-based case for services for individual patients.
Speaking about this discussion, Dr. Marshall stated, “We were always thinking, ‘If we could only have x, it would make our patient care so much better’. But then we realized that it wasn’t that simple”. Shifting their focus away from securing better services and more towards working collaboratively together has felt like a constructive step for the group. A positive by-product of the meetings was enabling everyone in the group to meet each other face to face (albeit virtually due to COVID). “We work at different sites and a lot of people haven’t met each other before”, said Dr. Marshall.
A big thank you to Dr. Jeanine Marshall, Dr. Jennifer Oates, Dr. Chris Blashko, Dr. Brad Williamson, Dr. Alice Cojocaru, and Dr. Alison Gregson for their commitment to improving care for this population!