GIMRAC development, model of care, support of admission avoidance and decreased length of stay
Notice bibliographique
Résumé
Abstract Hallway medicine has taken a forefront in Ontario Healthcare and is influencing patient care. The Conservative party is focused on increasing fiscal responsibility. Joseph Brant Hospital’s General Internal Medicine Rapid Assessment Clinic (GIMRAC) was initiated in 2016 in an effort to decrease hallway medicine and assume that fiscal responsibility by having the right patient in the right place at the right time. Appropriate patients are referred from the Emergency department and Inpatient units and provided with a timely assessment by an internal medicine physician in a clinic setting close to home. The GIMRAC has prevented over 3500 hospital admissions and allowed for over 800 early discharges since its inception. Volumes have increased by greater than 350% to date. Specialty medical care, collaboration between departments, and an intense focus on client centered care, have supported these numbers. The governance of an Ambulatory Care Steering Committee and consistent monitoring of metrics amongst staff, leadership, and finance, has provided the transparency and accountability needed to further grow. A review of community needs allows for proper alignment of care within the clinics. A realignment of resources and co-location of clinics, allows for visibility, cross training of staff, and collaboration of expert care. The aim of this presentation is to inform conference attendees about the type of patient optimal for this model of care, challenges surrounding referrals, follow up, limited resource utilization, and barriers to further growth. Strategies related to the daily dynamics between frontline providers (ie., physicians, nurses, and hospital administration) will be outlined. Biography Dr. Nada Elmazariky Dr. Elmazariky is a graduate of McMaster University where she studied Internal Medicine and was nominated for Chief Resident at Juravinski Hospital. Dr. Elmazariky is a Fellow of the Royal College of Physicians and Surgeons of Canada where she became an academic representative for the Internal Medicine Fellows and a Certified Specialist in Internal Medicine. Dr. Elmazariky has been working at Joseph Brant Hospital (JBH) since 2016. She has led the development of the GIMRAC Clinic and been the physician lead for the Preoperative Medicine Clinic. Dr. Elmazariky has been instrumental in designing and teaching internal medicine electives for residents. Presenting author details Full name: Dr. Nada Elmazariky Contact number: 1-647-808-6434 Session name/ number: Category: Oral presentation Biography Tracy A. Fazzari Tracy Fazzari is the Manager of Oncology, Endoscopy and Ambulatory Care at Joseph Brant Hospital (JBH), board member of the Canadian Association of Ambulatory Care and member of the Canadian College of Health Leaders. She has a Master of Science in Speech Pathology with over 18 years clinical experience and 12 years lecturing within the university which has supported her interest in patient centred care and provided the foundation for leadership. Tracy participated in the redevelopment project at JBH gaining operational skills necessary to develop the Ambulatory care clinics. Tracy has an interest in leadership, mentorship, collaboration and clinic development.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,008 | 0,024 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,005 | 0,002 |
| Science ouverte | 0,003 | 0,005 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,013 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».