Geriatric Assessment Team: From 1 Different Sources
See “aged care assessment team”.
Consists of members of different disciplines, involved in the same task (assessing people, setting goals and making care recommendations) and working along side each other, but functioning independently. Each member undertakes his or her own tasks without explicit regard to the interaction. These teams are traditionally led by the highest ranking team member.... multidisciplinary team
See “geriatric assessment”.... assessment
The branch of medicine specializing in the health and illnesses of old age and the appropriate care and services.... geriatric medicine
This is a structured, multi-disciplinary process for assessing and improving the health consequences of projects and policies in the non-health sector. It combines a range of qualitative and quantitative evidence in preparing conclusions. Applications of the assessments include appraisal of national policies, local urban planning, and the progress of transport, water and agricultural projects.... health impact assessment
A systematic procedure for determining the nature and extent of problems experienced by a specified population that affect their health, either directly or indirectly. Needs assessment makes use of epidemiological, sociodemographic and qualitative methods to describe health problems and their environmental, social, economic and behavioural determinants. See also “geriatric assessment”.... health needs assessment
Consists of members who work together interdependently to develop goals and a common treatment plan, although they maintain distinct professional responsibilities and individual assignments. In contrast to multidisciplinary teams, leadership functions are shared.... interdisciplinary team
The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences.... risk assessment
In this team, each member becomes so familiar with the roles and responsibilities of the other members that tasks and functions become interchangeable to some extent. This type of team is difficult to operationalize.... transdisciplinary team
Multidisciplinary team of health professionals that is responsible for comprehensive assessments of the needs of older persons, including their suitability for hospital, home or institutional care.... aged care assessment team
A process that allows a person who has been assessed to dispute the assessment, and which provides for the assessment to be changed.... assessment appeal process
A structured process developed to ensure that assessment is relevant, consistent, fair and valid. The system requires rules of operation, a regular review process and competent assessors.... assessment system
Intended as a key part of the NHS’s local comprehensive mental health services serving populations of around 50,000, these multidisciplinary, multi-agency teams have been less e?ective than expected, in part due to varying modes of operation in di?erent districts. Some experts argue that the services they provide – for example, crisis intervention, liaison with primary care services and continuing care for long-term clients – could be delivered more e?ectively by several specialist teams rather than a single, large generic one comprising psychiatrists, psychologists, community mental health nurses, occupational therapists, support and (sometimes) social workers.... community mental health teams
A process which includes a multidimensional assessment of a person with increasing dependency, including medical, physical, cognitive, social and spiritual components. Can also include the use of standardized assessment instruments and an interdisciplinary team to support the process.... comprehensive geriatric assessment (cga)
Multidimensional, interdisciplinary, diagnostic process used to quantify an older individual’s medical, psychosocial and functional capabilities and problems, with the intention of arriving at a comprehensive plan for therapy and long-term follow-up.... geriatric assessment
Care of older persons that encompasses a wide range of treatments from intensive care to palliative care.... geriatric care
A facility specializing in services for older persons which include acute care, geriatric assessment, rehabilitation, medical and nursing services, therapy services and residential care.... geriatric centre
A group comprising a variety of professionals (medical practitioners, nurses, physical and occupational therapists, social workers, pharmacists, spiritual counsellors), as well as family members, who are involved in providing coordinated and comprehensive care. There are three types of health care team, defined by the degree of interaction among members and the sharing of responsibility for care:... health care team
The systematic evaluation of properties, effects and/or impacts of health care technology. It may address the direct, intended consequences of technologies as well as their indirect, unintended consequences.... health care technology assessment (hcta)
A group of persons working together, where each member of the team contributes, in accordance with his or her competence and skill and in coordination with the functions of the others, in order to achieve the maximum benefit for the care recipient.... health team
The systematic evaluation of the properties, effects or other impacts of health care technology. HTA is intended to inform decision-makers about health technologies and may measure the direct or indirect consequences of a given technology or treatment.... health technology assessment (hta)
An assessment of people with health and social care needs by two or more professionals from different disciplines.... multidisciplinary assessment
Screening and surveillance uncover problems which then need careful attention. Most NHS districts have a CDT to carry out this task – working from child development centres – usually separate from hospitals. Various therapists, as well as consultant paediatricians in community child health, contribute to the work of the team. They include physiotherapists, occupational therapists, speech therapists, psychologists, health visitors and, in some centres, pre-school teachers or educational advisers and social workers. Their aims are to diagnose the child’s problems, identify his or her therapy needs and make recommendations to the local health and educational authorities on how these should be met. A member of the team will usually be appointed as the family’s ‘key worker’, who liaises with other members of the team and coordinates the child’s management. Regular review meetings are held, generally with parents sharing in the decisions made. Mostly children seen by CDTs are under ?ve years old, the school health service and educational authorities assuming responsibility thereafter.
Special needs The Children Act 1989, Education Acts 1981, 1986 and 1993, and the Chronically Sick and Disabled Persons Legislation 1979 impose various statutory duties to identify and provide assistance for children with special needs. They include the chronically ill as well as those with impaired development or disabilities such as CEREBRAL PALSY, or hearing, vision or intellectual impairment. Many CDTs keep a register of such children so that services can be e?ciently planned and evaluated. Parents of disabled children often feel isolated and neglected by society in general; they are frequently frustrated by the lack of resources available to help them cope with the sheer hard work involved. The CDT, through its key workers, does its best to absorb anger and divert frustration into constructive actions.
There are other groups of children who come to the attention of child health services. Community paediatricians act as advisers to adoption and fostering agencies, vital since many children needing alternative homes have special medical or educational needs or have behavioural or psychiatric problems. Many see a role in acting as advocates, not just for those with impairments but also for socially disadvantaged children, including those ‘looked after’ in children’s homes and those of travellers, asylum seekers, refugees and the homeless.
Child protection Regrettably, some children come to the attention of child health specialists because they have been beaten, neglected, emotionally or nutritionally starved or sexually assaulted by their parents or carers. Responsibility for the investigation of these children is that of local-authority social-services departments. However, child health professionals have a vital role in diagnosis, obtaining forensic evidence, advising courts, supervising the medical aspects of follow-up and teaching doctors, therapists and other professionals in training. (See CHILD ABUSE.)
School health services Once children have reached school age, the emphasis changes. The prime need becomes identifying those with problems that may interfere with learning – including those with special needs as de?ned above, but also those with behavioural problems. Teachers and parents are advised on how to manage these problems, while health promotion and health education are directed at children. Special problems, especially as children reach secondary school (aged 11–18) include accidents, substance abuse, psychosexual adjustment, antisocial behaviour, eating disorders and physical conditions which loom large in the minds of adolescents in particular, such as ACNE, short stature and delayed puberty.
There is no longer, in the UK, a universal school health service as many of its functions have been taken over by general practitioners and hospital and community paediatricians. However, most areas still have school nurses, some have school doctors, while others do not employ speci?c individuals for these tasks but share out aspects of the work between GPs, health visitors, community nurses and consultant paediatricians in child health.
Complementing their work is the community dental service whose role is to monitor the whole child population’s dental health, provide preventive programmes for all, and dental treatment for those who have di?culty using general dental services – for example, children with complex disability. All children in state-funded schools are dentally screened at ages ?ve and 15.
Successes and failures Since the inception of the NHS, hospital services for children have had enormous success: neonatal and infant mortality rates have fallen by two-thirds; deaths from PNEUMONIA have fallen from 600 per million children to a handful; and deaths from MENINGITIS have fallen to one-?fth of the previous level. Much of this has been due to the revolution in the management of pregnancy and labour, the invention of neonatal resuscitation and neonatal intensive care, and the provision of powerful antibiotics.
At the same time, some children acquire HIV infection and AIDS from their affected mothers (see AIDS/HIV); the prevalence of atopic (see ATOPY) diseases (ASTHMA, eczema – see DERMATITIS, HAY FEVER) is rising; more children attend hospital clinics with chronic CONSTIPATION; and little can be done for most viral diseases.
Community child health services can also boast of successes. The routine immunisation programme has wiped out SMALLPOX, DIPHTHERIA and POLIOMYELITIS and almost wiped out haemophilus and meningococcal C meningitis, measles and congenital RUBELLA syndrome. WHOOPING COUGH outbreaks continue but the death and chronic disability rates have been greatly reduced. Despite these huge health gains, continuing public scepticism about the safety of immunisation means that there can be no relaxation in the educational and health-promotion programme.
Services for severely and multiply disabled children have improved beyond all recognition with the closure of long-stay institutions, many of which were distinctly child-unfriendly. Nonetheless, scarce resources mean that families still carry heavy burdens. The incidence of SUDDEN INFANT DEATH SYNDROME (SIDS) has more than halved as a result of an educational programme based on ?rm scienti?c evidence that the risk can be reduced by putting babies to sleep on their backs, avoidance of parental smoking, not overheating, breast feeding and seeking medical attention early for illness.
Children have fewer accidents and better teeth but new problems have arisen: in the 1990s children throughout the developed world became fatter. A UK survey in 2004 found that one in ?ve children are overweight and one in 20 obese. Lack of exercise, the easy availability of food at all times and in all places, together with the rise of ‘snacking’, are likely to provoke signi?cant health problems as these children grow into adult life. Adolescents are at greater risk than ever of ill-health through substance abuse and unplanned pregnancy. Child health services are facing new challenges in the 21st century.... child development teams (cdts)
The ongoing process of evaluating the health needs of a community. Usually facilitates prioritization of needs and a strategy to address them.... community health needs assessment
See “geriatric assessment”.... needs assessment
Standardized tools to determine patient characteristics and abilities, what assistance they need and how they may be helped to improve or regain abilities. Patient assessment forms are completed using information gathered from medical records, interviews with the patient, other informants (e.g. family members) and direct observation.... patient assessment (resident)
QAPI establishes strategies for promoting high quality health care. First, each organization must meet certain required levels of performance when providing specific health care and related services. Second, organizations must conduct performance improvement projects that are outcome-oriented and that achieve demonstrable and sustained improvement in care and services. It is expected that an organization will continuously monitor its own performance on a variety of dimensions of care and services, identify its own areas for potential improvement, carry out individual projects to undertake system interventions to improve care, and monitor the effectiveness of those interventions.... quality assessment and performance improvement programme (qapi)
The process whereby a person is assessed for care needs using one form/mechanism so that agencies do not duplicate each other’s assessment.... single assessment process
(Irish) In mythology, a place where kings met Teamhaire, Teamhare, Teamharre... teamhair
The process whereby a group of people work together (often by dividing tasks among members, based on relative skills) to reach a common goal, to solve a particular problem, or to achieve a specified set of results.... teamwork
A comprehensive form of policy research that examines the technical, economic and social consequences of technological applications.... technology assessment
(AOT) a multidisciplinary psychiatric team specialized in the treatment of patients with severe mental illness who are difficult to engage. Most AOTs will only see patients who have had a number of recent hospital admissions (‘revolving door’ patients). Recently, in many areas of the UK AOTs have been subsumed into *community mental health teams.... assertive outreach team
a designated team of doctors in a hospital who attend *cardiac arrests as they occur and administer protocol-driven treatment according to the latest guidelines. See also medical emergency team.... cardiac-arrest team
(CMHT) a multidisciplinary team consisting of psychiatrists, psychiatric nurses, psychologists, social workers, and occupational therapists who treat patients with severe mental illness in the community.... community mental health team
(CRHT) (in psychiatry) a multidisciplinary team in psychiatric services specialized in the treatment of severely mentally ill patients in their home environment. An additional remit of CRHTs is to try and avoid acute hospital admissions.... crisis resolution and home treatment team
(MET) a team, usually consisting of a group of physicians, anaesthetists, and senior nurses, that can be summoned urgently to attend to patients with deteriorating medical conditions. The aim is to prevent further deterioration and to decide if enhanced levels of care are appropriate (e.g. on the high-dependency or intensive care units). The team will also assume the role of the *cardiac-arrest team.... medical emergency team
(NCAS) see Practitioner Performance Advice.... national clinical assessment service
an interviewing technique that combines psychiatric history taking with elements of problem solving in *psychotherapy: after a psychiatric history has been elicited, the interviewer summarizes the patient’s difficulties and offers potential solutions. It is often used in patients who have presented with *deliberate self-harm, and research suggests that it offers the possibility of reducing repetition rates in such patients.... psychosocial assessment
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