2024年4月13日发(作者:)
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帮助老龄人“就地养老’’
体验格伦罗斯康复医院
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Helping Seniors‘'Age in Place”:
the Glenrose Rehabilitation Hospital Experience
文/IsabeI Henderson,Grace Maier&Susan Muirhead
翻译/林妍婷LIN Yanting
Isabel Henderson,格伦罗斯康复医院首席运营官
Grace Maier/格伦罗斯康复医院老人病学专业主任
Susan Muirhead/格伦罗斯康复医院顾问
※特别鸣谢施密特·费尔德伯格·克罗尔和事德森建筑公司(Schmidt Feldberg Croll&Henderson,Architects)及
其负责人克雷格‘事德森(Craig JB Henderson)对西格伦的设计。
摘要:本文介绍了格伦罗斯康复医院(GRH)为残疾人士和老年人提供的多种辅助功能。该医
院由艾伯塔省埃德蒙顿的医疗服务中心(AHS)运营,是一家专业的三级康复中心。文中强调
了与建筑设计、专业技术和临床编程相关的辅助功能。GRH很荣幸能够成为老年友好设计的
获得者。作为一家学术教学医院。这家加拿大医疗机构与社区、学术界、技术和行业合作伙伴开
展了重要合作,这些合作伙伴共同致力于推进无障碍方案。国际访问者经常参观GRH院区.
以了解更多有关医院的创新计划和设计特色。GRH不断检视国际护理、研究和创新市场,借
鉴领先实践经验。以支持老年人的功能独立性和生活质量。
关键词:康复医院设计、政策制定、研究和创新、就地养老、老龄人项目
Abstract:This article profiles the many accessibility features available for seniors and
patients with disabilities at the Glenrose Rehabilitation Hospital(GRH),a specialized
tertiary rehabilitation centre which operates within Alberta Health Services(AHS)in
Edmonton,Alberta.Accessibility features related to architectural design,specialized
technologies,and clinical programming are highlighted.The GRH prides itself on being
a recipient of the Senior Friendly designation.As an academic teaching hospital,this
Canadian facility has developed significant collaborations with community,academic,
technology and industry partners who all work together to advance accessibility
options.International visitors routinely tour the GRH campus to learn more about the
hospital’s innovative programs and design features.The GRH continuously scans the
international care,research and innovation markets to draw upon leading practices that
will support functional independence and quality of life for older adults.
Keywords:rehabilitation hospital design,policy making,research and innovation,aging in
place,senior programs
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引言
格伦罗斯康复医院(The Glenrose Rehabilitation Hospital,以下简
称GRH)位于加拿大艾伯塔省的省会埃德蒙顿。它是艾伯塔卫生服务
机构(Alberta Health Services,简称AHS)下的一个学术性教学医
院,每年为超过20,000位病人提供服务,并且由1 500多名医生与
工作人员,以及超过1,000名学生、1O0名研究人员和400名志愿者
组成。GRH在向各年龄层提供专业的老年病学和复合康复咨询方面,
是康复行业公认的领导者。医院拥有244个床位,每年接纳762位住
院病人和提供76。1 30次门诊服务。多年来,GRH在推进临床研究方
面取得了长足的进步,并且开创了多种创新技术,直接改善了患有身体、
认知、心理和社交障碍老年人的生活(图1~图3)。这与我们的愿
景——为生活创造能力(Building Abilities for Ljfe )以及世界卫生
组织关于功能、残疾和健康的国际分类fInternational Classification
of Functioning,Disability and Health,以下简称ICF)的模式一致,
这些创新的目标通过考虑病人或家属的需要,来改善病人的能力和独
立性,同时帮助病人提高社交参与的自信,为社会交流和贡献创造机会。
通过一系列先进的家庭监测和辅助科技,在安全、环境控制、药物管
理和活动能力方面,帮助社区中老人的家庭生活,让功能性的独立得
以实现。成立于1 994年的格伦罗斯康复医院基金会,其目的是通过
创新技术、先进设备、领先的研究和对格伦罗斯康复医院病人舒适性
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的重视,来改善对病人的护理。多年来,基金会的董事会对促进医院的独特地位,起到了至关重要的作用。格
伦罗斯的朋友(The Friends of Glenrose),是~群为病人护理和医院舒适而筹款的志愿者,五十年来一直在
支持着医院。
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建筑设计的思考
1.GRH现状
GRH占地13.6英亩,包括了四个主要建筑:西格伦(GlenWest)、东格伦(GlenEast)、能量中心(
Energy Centre),以及技术研究中心(Research Technology Centre)(图4)。它们各自的设计特点如下。
④西格伦:西格伦(于1 990年开放)的场地规划非常紧凑和高效,包括了地面4层以及地下室半层的服务
与支持区。一个通道系统将GRH与院区中相邻的两个医疗场所连接起来。西格伦的标志性设计对GRH获得
三级康复医院的资质,起到了关键作用(建筑图见附录)。4个楼层的组织结构如下:
·第一层:接待区、用餐区,以及服务区
·第二层:行政区、门诊区,以及诊断区
·第三层和第四层:建筑规划时,我们主要考虑到这两层需要208张病床,即每层1O4张。建筑规划中的一
个关键问题是,在第三层需要建造支撑地板,但规划的面积却非常狭小。设计团队提议在楼层间建造4个双层
中庭。这样在起到关键支撑作用的同时,为病人和员工提供最佳的环境。中庭有丰富的自然光,提供了一个令
员工振奋的工作环境,也营造了一个有助于病人病情恢复的疗养环境。
在西格伦的设计中,一个主要规划策略是建立定向的人员流动,以及为病人/访客提供路线指引。带中央电梯
的大厅和清晰直接的路线指引实现了对三层和四层的四个护士站的路线引导,同时也有助于员工的安全和对病
人的保护。在建造的过程中,顶层的104张病床被改造成适合老年病的床位。在规划设计中,单人和双人床位
病房的主要出口需要通向一系列有工作人员的工作问。普通的双人间包括了入口、卫生间和两张用帘子隔开的
病床。如果拉上帘子,里面的那张床就照不到阳光。设计师们突破性的建筑规划,是将可隔成单人间的双人间,
与普通双人间组成菱形的平面。这样,每张床的病人都能看到窗,也可共享卫生间的通道,员工和访客也能安全
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进入。另外,考虑到病人和员工安全,坐便器与墙面保留了一定A,O ̄E离
让护理人员能从左边或右边帮助移动病人。
· 走廊/过道——宽阔、防滑的地板;用地板材料控制噪声;无眩目
照明;用于指导活动的壁画;与墙面颜色不同的墙壁扶手;在不同区
间有用于休息的长椅;适合大型移动设备(电动轮椅、滑板车、童车、
②东格伦:东格伦于1973年竣工,进一步完善了最初在1964年正
式开放的GRH。东格伦承接了儿童和青少年心理健康中心(Children
超宽手动轮椅)的地方。
·用一般的装饰和色彩,营造一个舒适、安全的环境;用更亮的颜色
进行区分;用对比色来勾画物体和层次,以及改善对深度感知和判断
巨离的台 力。
·大型电梯——用于运送住院病人;根据不同残疾人设计的可替换楼
and Adolescent Mental Health]的儿科项目,包括1 O张儿科康复
的床位、26张住院病床,以及一系列移动医疗项目和格伦罗斯学校。
连接东格伦和西格伦的建筑包括:小型餐厅(Cafeteria)、游泳中心(
Aquatics Centre)、体育馆(Gymnasium),和比尔·布莱克博士大
会堂f Dr.Bill Black Auditorium)。
梯;可容纳病人饮食和药物运输推车;日用品和亚麻制品的运输;紧
急停止和出入口。
·多个洗手台。
③格伦罗斯康复科研与创新技术中心:格伦罗斯康复科研与创新技术
中心是一座历史性建筑。它是研究人员的聚集地,并且建有一系列的
实验/会议室和员工/学生办公室。
· 指定体重——为患有病态肥胖A91"3诊病人和普通病人提供有称重功
能的出入口。
·卫生间——整个医院有多个可通行轮椅的卫生问;男女共享;适合
关节病病人和护理人员出入;可抓取的扶手;接入了紧急警报装置;
④GRH能量中心:能源中心为格伦罗斯以及和它相邻的两个园区内
的医疗场所,提供暖气和冷气。
在儿科区域有供儿童使用的较低坐便器。
·专用区域——美发沙龙;可通行轮椅的洗头池和沙龙座椅。
· 温馨/激励的环境——墙上有艺术作品,由艺术与康复委员会提供
2,GRH的设计特点
f Arts in Rehab Council);在儿科有适龄的墙画和油漆色;穿透天窗
和大窗户的自然光线;有户外景观。
2018年,我们完成了整个项目的总体规划与扩展计划。最近,更多
GRH的未来规划被添加进了201 3年完成的《2030年规划》。
·经过伪装的出口,防止痴呆症患者乱走出去。
④特定的室内医院特征:
·公用/共享区域(供员工、医生、病人、家属、一般公众使用)(图5)
·为场所内的病人/家属以及员工提供无线上网服务
③候诊区/病人及家属休息区:
·适龄的家具;不同高度和宽度的座椅(肥胖症、关节炎);宽阔和
足够的座位。
·与检查区和其他诊所相邻或步行距离短。
②无障碍设计/设施:
· 机构出入口——在正门入口处和校车入口处,有用于接送病人的区
域;街道入口处有成人及儿童登记/信息处;主要入口处有宽大的双
开自动门;宽阔、开放的门厅;容易阅读的导路标志;无障碍地下停
车拱廊和毗邻医院入口的指定的地面小隔间。
④公众用餐区:
· 咖啡厅——可移动的桌椅,以适应轮椅使用者;温馨的环境;适合
轮椅高度的桌子;与三层的成人/老年人住院区相邻;用盆栽或其他
绿色植物来提供私密性(图6)。
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· 小餐馆——取餐区之间有足够宽的距离;轮椅高度的自助柜台;可
移动的桌椅,以适应个人或多人的环境;桌子问有足够大的空间,以
适应使用移动辅助设备的人;墙上的照片描绘了临床环境:电视直播
功能;展示个人和集体奖项。
⑤教育/会议区:
· 比尔·布菜克博士大会堂——轮椅座椅;带坡道的层级式座位;视
频会议功能;适合肥胖症患者。
·病患图书馆——提供一般图书馆的服务;支持计算机的个人借阅机;
为病人/家属提供大量关于残疾的书籍/多媒体产品。
· 病人家属资料室——提供和社区服务有关的介绍手册、小册子、信
息。
⑥员工区(直接供员工使用,或用于满足员工需求):
· 员工休息室——在指定工作休息时间时使用:非正式员工的社交;
可以使用电脑(图7)。
· 日托——员工和一般大众;经授权和认可fig)L童看护项目;最多允
许30名儿童和8名员工(具有照顾有特殊需要儿童的经验)参加;
为上午茶和下午茶以及音乐节目提供空间;为学龄前儿童提供发展性
的相应游泳项目;游乐场(图8)。
·员工健身中心——每周7天每天24小时开放。有健身器材、专业
课程:提供私人教练;淋浴/更衣室;自行车房。
⑦治疗区(移动医疗支持康复治疗师的治疗活动,如物理治疗、作业
治疗、沟通障碍、康娱治疗、听力学):
·f-3诊室——宽敞的会议/病患检查室,有电子白板和远程医疗技术。
·体育馆——大型、开放的空间,支持健身班、团队运动(篮球、排球、
轮椅舞);减轻跌伤的专业地板(图9)。
· 游泳中心——公共娱乐和治疗性游泳的两用空间。特点包括:用于
通行轮椅的长坡遣在坡道和台阶处有支撑栏杆水上用的轮椅和担
水下双杠(可拆卸);有木地板的淋浴;泳池边有安全护栏小型水滑梯;
辅助设备(图1O)。
· 技术中心——由多个卫星中心组成,如建立艾伯塔勇气交流中心
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(BTACC)、有勇气去运动(CIM)中心、我能行中心、运动与平衡一
体化中心(SCMB)、模拟中心、GRH油人互动学习(OlL)中心。这
些中心有最先进的数字化、交互式和电子化的游戏活动,整个场所都
接入了远程医疗(图11~图13)。
⑧专业诊疗区:
·牙科诊所一一可通行轮椅与担架,并配有用于吊抬卧床患者的转运
装置(包括肥胖患者),以及大型检查室,以便学生学习和家属参与(图
14)。
·性健康服务——可通行轮椅、高度低的检查台。
· 放射学/影像透视——专业设备,也可用于尿动力学和吞咽困难的
检查。
·心脏康复项目——可通行轮椅;自然光;适合残疾人和/或需要心
脏康复病人的专门设备。
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15病房
人警报系统、适合视力或听力缺失或残疾的人的住所;结合创新技术)。
力诊断间——多重的隔声 可通行轮椅;用于前庭实验的专门实
人工耳蜗检查/检测。
⑩科研开发:
· 康复研究中心——用来开发科技类工具的小工作区,以便用于提升
病人能力和独立性,如步态障碍、脊柱弯曲、截肢和3D假肢;计算
疗区——宽阔开放的空间;自然光;适龄和无障碍的运动区域和
适合使用移动辅助设备的大空间;运动用床和平台的大小符合
j安全需要和转移能力;低的垫子;用于存放儿科治疗用玩具的
机辅助技术;机器人、虚拟现实、认知学习、用于测试技术的使用的
大区域;研究生的空间;用于研究人员共同解决问题的一般区域。
在冰箱能取用医药品(包括痉挛诊所的使用)。
^\护理/家属区(主要住院区):
旁一一舒适的居住环境;保障个人隐私和尊严;可选的隔离房;能
⑩医院外部的特点:
· 外部景观——通过每年种植在春夏秋开花的植物,给病人/家属和
访客营造一种宾至如归的美丽景色;散步的小路;病人园艺区、散步/
轮椅用的路。每年夏天在前方草坪上有蔬菜园——可供病人和当地居
民食用。
·游乐场/娱乐区——设备支持残疾儿童;日托儿童;成人/老年人
[造成家庭环境;卫生问有扶手和增高的坐便器座椅;床边有个人
白色)板(目前的护理计划、限制、移动和治疗活动)(图15)。
的专业病房一病人隔离;肥胖病人(E匕一般病房大);大型
有超大尺寸的门的卫生间;带密码锁的单元(脑部损伤、痴呆症)。
人用餐问一一明亮和愉快;可移动的桌椅;支持个人或集体用餐
6)。
休息室——环境变化;看电视;通过社交媒体与亲朋好友联系;
]躺椅。
芰设施——与成人/老年人病房单元相邻。
单独的娱乐区/治疗平台(如散步、篮球区;配有长椅的固定野餐桌)。
· 停车/可通行的交通——除了地下停车场,还有三个露天停车场供
访客/员工使用。也可搭乘轻轨和公交到达医院附近。
二、政府,政策制定者
GRH与地方、省级和国家卫生服务机构以及政府部门,有着长期的合
作关系,能在改善老年人无障碍化和生活/护理环境方面,影响政策
的制定。下面是一些例子:
2生活套房——近期完成升级,有家一样的氛围(过渡期病院楼,
:的卧室、厨房、卫生间、客厅);有辅助和通信技术,保障病
全和提升病人的能力(如可语音激活的移动电话、可穿戴的病
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持续护理解决团队fCCRT
由艾伯塔卫生服务机构(AHS)建立,为对持续护理安置和照顾有困难的客户和家庭提供帮助。GRH
委派两人一组的团队,并与持续护理解决团队的领导人、AHS的其他人员和社区伙伴团体密切合作,
来解决公共和私营持续护理设施和那些与家庭护理服务相关的问题。基于1 000多个客户/家庭、一线
员工、设施领导、社区利益相关者和学术、科技、商业和行业伙伴的反馈,团队提出了17个解决问题
的建议,包括六个方面:出入、中转、交流、设施、护理质量和其他正在进行的工作,并根据建议来改
善服务。
一
个被称为家的场所
2O16年,GRH召开省级座谈会。会议针对AHS持续护理解决团队所提出的17项建议进行介绍并展
开讨论,并将住在自己家、辅助式生活或长期护理环境的个人,列入持续护理的定义中。提议的重点放
在实施为特殊群体的整个生命周期所做l ̄9N新型、转换型护理模式,比如护理虚弱的老年人以及那些患 '
有痴呆、精神健康问题、脑损伤、多发性硬化症、保守治疗/Il缶终关怀,以及发育性残疾和自闭症的人群。
埃德蒙顿老龄友好城市
GRH是埃德蒙顿老龄友好城市的成员之一,目标是建设一个重视、尊重,并积极支持老年人福祉的城市。
它是一个包容性的地方,老年人能参与到社区中、为社区做贡献、在家中感到安全美好、受尊重和被包
容,并能接触到他们所需的项目、服务以及资源。由埃德蒙顿市和埃德蒙顿老年人协调委员会共同领导
的埃德蒙顿老龄友好城市,与致力于当地活动的组织有着合作关系。格伦罗斯医院也为埃德蒙顿的子团
体——住房,以及生活之家准则和网站的建设,作出了显着的贡献。生活之家的准则概述了建造一个能
满足个人各年龄段和生命各阶段需求的住宅所必备的辅助功能(图17)。
老年人无障碍住房的市长圆桌会议——让我们的房子变成一辈子的家
2009年,GRH与埃德蒙顿的前任市长(史蒂芬·曼德尔)合作,召开了面向老年人群关于无障碍化
的会议,分享了关于老年人无障碍住房的创新研究、资源和模式。会议产生了一份大纲,确定了在埃德
蒙顿鼓励和扩大无障碍住房选择的战略。
建立艾伯塔勇气交流中心
建立艾伯塔勇气交流中心(BTACC)所提供的康复服务,是运用科学技术来帮助有身体和认知问题的人
·虚拟现实舱,配有能让病人与虚拟环境交互的硬件和软件
·适合的模拟驾驶器,帮助客户重新学会驾驶
·步态训l练的辅助机器人(Lokomat),帮助客户重新学会走路
·配有电脑和智能板的教室
·压力传感垫,并覆盖有持续压力成像,以用于评估压伤的风险
·技术支持,展示在康复治疗中有前景但未广泛应用的创新科技
未来设计
临床设计师负责设计新技术和提出创造性的解决办法,以解决没人能够解决的问题,可以是急救的医疗
设备,或是旨在改善残疾人功能性和独立性的技术。GRH康复科研与创新技术开发团队与艾伯塔大学
的工程系和生物工程部密切合作,不断为工程专业的本科生和研究生提供担任研究对象、课外研究项目
以及接触技术设计的研究与开发方面的机会。整个医院建立了许多科技的初步设想,包括改善老年人行
动能力和功能性独立的辅助科技。
埃德蒙顿健康之城
埃德蒙顿是加拿大医疗研究的核心,并且是卫生保健行业内的先驱。2016年推出的这项新战略,其重
点是通过增加地方卫生行业公司的融资渠道,加速新科技新产品的商业化,并吸引和留住顶尖人才、资
埘
THE ME
金和伙伴关系,来推动埃德蒙顿成为世界级的健康创新城市。
贸易代表团
GRH与致力于帮助新兴科技公司成长的埃德蒙顿科技、企业与公司发展(TEC Edmonton)保持着定期合
作关系。贸易代表团是将埃德蒙顿创新名扬海外的方式之一,同时为开拓新市场、展示技术和建立国际关
系提供了宝贵的机会。近期贸易代表团!ao, ̄lJ子包括:
· 艾伯塔医疗器械代表团参加中国国际医疗器械博览会(CMEF),重点展示了医疗产品(可穿戴式、电子
式、急救式、诊断式等等)。
·艾伯塔科技贸易代表团参加201 7世界移动通信大会(MWC),重点展示了与移动通信相关的软件、硬件、
医疗保健等等。
军用计算机辅助康复环境(CAREN)的设计
在加拿大西部首次出现的计算机辅助康复环境,是一个临床的虚拟现实模拟器(图18)。它正为格伦罗斯
所有年龄段的病人和有身体和心理损伤的加拿大军队人员的康复治疗提供巨大帮助。CAREN以有趣、安
全和创造对身体与认知有挑战性的方式,优化了康复体验和效果。
老年人友好医院
老年人友好医院致力于改善老年人的健康状况、在医院中防止他们身,bA99 ̄,并通过坚定的领导、护理
人员过程和老年人友好物理空间来优化他们的康复体验和效果。
031 主题报道
THEME REP0RT
目夏治疗
均场景
临床医
的护理
肉志愿者
加拿大安大略省和艾伯塔省是加拿大老年人友好医院理念的领导者。安大略制定出循证医学的蓝图,来指导全
医院对体弱老年人服务的改善。GRH于2007年受到艾伯塔委员会关于老年人友好养老的指定。在艾伯塔卫
生服务机构下的老年人健康之战略性的临床网络框架内,推进老年人友好医院的举措,以解决老年人在医院中
发生的所有潜在并发症。
医院规划:埃德蒙顿区2030年规划暨RAH/GRH/诺伍德园区规划与诺伍德资本护理(CapitalCare)的设计
咨询
为埃德蒙顿地区制定了一个综合、长期服务和基础设施计划,以确定该区域当前和未来的卫生保健需求。该计
划针对资源的有效分配、病人服务效果的改善、现有空间的利用和必要的扩大,同时为未来的增长和技术做出
计划。与2030年总计划相一致的另一项举措,重点放在制定埃德蒙顿地区内整个长期护理中康复和恢复护理
服务的简介。格伦罗斯参与了对诺伍德设施规划的讨论。设施将包括各类项目,以解决复杂持续护理需求、镇
痛拔牙(对特殊病人群体很重要),以及急性期后的服务。这些都突出了恢复/复原的护理方式(图1 9)。
与我们利益相关者合作(Partnering with our Stakeholders)
GRH认为应该与他人合作。合作是任何团队成功的基石。分享计划、制定决策、解决问题、设定目标、承担责任、
协同工作、沟通,以及公开协调,是改善项目成果和病人/家庭效果的关键因素。
格伦罗斯轻松行动项目
轻松移动项目是加拿大西部惟一的此类措施,鼓励大学生志愿者在课后时间和周末去看望老年人,并鼓励老年
人在度过高质量社交时间的同时,尽量去走动(图2O)。行动能力下降和体能失调是老年患者住院所产生的
主要并发症。不动的危害包括肌肉质量和力量的丧失,而这会增加跌倒的风险;肺容量减少;焦虑、压抑、无
助感和食欲不振。
三、研究与创新
GRH高度重视研究和创新。将新知识和技术纳入并整合到康复护理中,对改善病人效果是非常重要的。为此,
GRH努力提高其能力,以吸引来自世界各地的顶尖人才、寻求融资机会与合作伙伴,来更好地支持未来的研
究和培养创新领导者。
畦E 殳亡 主题报道
REP0RT
董生 堇
老年科技作为一个新兴的领域,着重于发展应用科技用于老年人和护理人员福祉的仪器、设备和理念,
并以独立生活、安全住房和社会交流为目标。例子包括安全监测器、跌倒预测/检测器、药物粘附检测
器、电动移动装置,以及交流和环境帮助。在GRH内,这些设备和帮助在我能行中心内经过试用,以
测试其辅助科技,以及独立生活套房,以帮助病人安全地重回他们的家中和社区。
格伦罗斯医院独立生活套房
独立生活套房(ILS),是一个类似家庭的环境,开放给格伦罗斯医院的病人及他们的家庭使用,用于进
行建立病人安全返家能力的评估和治疗活动(图21)。该套房也为改善老年人和残疾人能力的创新科
技和研究的结合,提供了独特的机会,并经常得到行业、商业和私营部门的支持。
学术合作
格伦罗斯医院与学术界建立并保持着有力的临床和研究合作关系。合作院校和项目的例子有:
·艾伯塔大学——康复医学、医学和牙科、护理、工程、生物工程、体育和娱乐
·麦科文大学——健康与社区研究院(护理、辅助治疗)
·北艾伯塔理工大学——(设计与通信、计算机系统程序)
·各类与合作研究和共同利益相关的加拿大和国际大学——自闭症、脊柱侧凸、[亘I定装置、辅助技术
和技术创新
格伦罗斯康复医院科研与创新技术(GRRIT
GRRIT是一项让医院走在医疗改革前沿的举措。创新者和行业合作开发技术解决方案,以解决临床问题、
功能缺陷和改进护理。合作产生的例子包括:辅助技术、用于提升精细运动的大触摸屏桌子、帮助病人
抓握对象的手套,以及用于建立爬梯能力信心 Ⅱ平衡的一组可调整楼梯。GRRIT所提出的一项创新,
便是我们的反向贸易展示会。在展示会中,医生为来自行业、学术界和当地投资者的观众讲解明确的问
题,战略部署了资本增长用于商业化科学和技术的优点(图22)。
荣誉和奖项一格伦罗斯的医生、员工、研究人员和志愿者在各方面不断受到认可,包括领导、提供杰
主题报道
THEME REP0RT
口亡
畦区
出服务、创新、科技发展和先进新知识。多年来,格伦罗斯的医生、员工和志愿者荣获多个奖项,
包括加拿大3M质量奖、女王纪念奖牌、加拿大勋章、埃德蒙顿市市长奖、将军总督的君主奖牌、
加拿大老年学协会颁发的罗纳德·开普杰出服务奖、杰出服务获AHS董事长杰出奖,而且包括
最近的201 7年加拿大鉴定之中风识别奖。201 7年,超过70位国外游客参观了格伦罗斯,学
习由医院提供的更多关于创新型康复技术、专业老年病学和病人与家庭的综合康复护理。
结论
老年人口是我们增长最快的人口,并且他们平均寿命比以前更长。格伦罗斯康复医院致力于帮
助有生理、认知或精神障碍和慢性疾病的老年人改善其功能性、独立性和社会参与。我们有先
进的护理人员培训、专业老年学的健康专家,并使用创新辅助和其他技术,提高质量并更好地
让老年人尽可能长时间地留在他们家中。我们将与学术、产业、政府和其他卫生保健合作伙伴,
一
同实现这一目标。作为一个团队,我们可以支持并帮助解决市级和省级优先考虑的养老住房、
辅助技术和无障碍服务事项。格伦罗斯康复医院不断探索国际护理、研究和创新市场,以借鉴
能为老年人功能性独立和生活质量提供帮助的最新实践(图23)。
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035 主题报道
THEME REPORT
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参考文献及网页
【1]Algase,Donna L,Elizabeth RA Beattie,Cathy Antonakos,Cynthia A Beel—Bates,and Lan Yao.
”Wandering and the Physical Environment.”American Journal of Alzheimer’s Disease&Other Dementias@
25,no.4(201 O):340—46.
[2]Becker,Franklin,Marino Bonaiuto,Elena Bilotta,and Mirilia Bonnes.”Integrated Healthscape Strategies:
An Ecological Approach to Evidence—Based Design.”HERD:Health Environments Research&Design
Journal 4,no.4(201 1):1 14—29.
[3】Calkins,Margaret P.”Evidence—Based Long Term Care Design.”NeuroRehabilitation 25,no.3(2009):
145—54.
·Accreditation Canada Stroke Distinction PrOgram
httDs://accred|tatlOn.ca/stroke—distinction/
‘Age Friendly Edmonton
https://www.edmonton ca/city
government/initiatives
inn0VatiOn,age—friendly—edmonton.aspx
——
Alberta Caregiver Colleges 一
http://www.caregiVercOllege.ca/
‘AHS Continuing Care Resolution Team(CCRT)Final Report(June 201 5)
o http://www.albertaheaIlhserVices ca/cc/Page1 3471.aspx
。AHS Continuing Care Expo 2016
http://www.albertaheaIthserVices.ca/assefs/news/ev/ne—ev—continuing—care—and—community—living—
expo一2016.pdf
http://www.a1berlaheaIthserVjces ca/news/Page1 3053.aspx
’AHS—GRH Building Trades of Alberta Courage Centre(BTACC)
http://www.aIbertahealthserVices.ca/grh/Pagel4501 aspx
·Brenda Stratford Foundation
https://www.stratfordfoundation.org/
‘Computer Assisted Rehabilitation Environment(CAREN)System
AHS—GRH Cou rage in MOtion Centre—httP://www.albe rtaheaIthse rvlces.ca,1nfo/fac…lv.
asDx?Jd=7822andserv『ce=1 056463
MP Hawn TO Help UnveiI The CAREN VirtuaI Reality MedicaI Treatment System At The Glenrose
Rehabilitation Hospital—http://www.forces.gc.ca/en/news/article.page?doc=mp—hawn—to—help—unveil—
the—caren—virtual—reality—medical—treatment—system—at—the—glenrose—rehab_li{afIOn—hOspitaI/hnps 1 v9b
Hospital News:Computer assisted rehabilitation environment—http://hospitalnews.corn/computer—
assisted—rehab…tation-environment/
Use of Ihe CAREN system as a treatment adjunct for Canadian Armed Forces members with chronic
non—specific low back pain:a pilot study—htlp:/ mvfh.utpjournals.press/doi/1 O.31 38 mvfh.201 4一O5
Recent developments In computer assisted rehabilitation environments https://mmrjourna1.biomedcentra1.
com/articles/1 0.1 1 86/2054一g36g一1—22
‘Dementia Village,De Hogeweyk,The Netherlands
YouTube https://www.youtube.com/watch?v=一qt7c43pKw
。Edmonton Health City
https://www.edmonton.ca/city
government/initiatives__nnovation/heaI{h—city—initiative.aspx
·Ger0fechnOl0qV
Statistics Canada Census—http://www1 2.statcan.gc.ca/census-recensement/201 6/as—sa/98—200一
x/2016O04/98—20O—x2O16004一eng.cfm
Macleans Canada Article 201 7一http://www.macleans.ca/news/canada/what—the—census—tells—us—
about—‘canadas——aging—‘population/
Technology for Adaptive Aging—health.oregonstate.edu/sites/health oregonstate.edu/.../DeMars—LIFE—
Scholars-Poster.ppt
037 主题报道
THEME REPoRT
·Homefor Life
Home for Life http://www.homeforlife.ca/
Canada Mortgage and Housing Corporation https://www.cmhc—sch1.gc.ca,en npr/bude/agpI/uplOad/
home—for—life.pdf
·Hospital Planning Edmonton Zone 2030 PlamRing
AHS 2030 Maste r PIan Edmonfon Zone Phase 1 FinaI Repo rl fDelailed)httP://www.
aIbertaheaIthservices.ca/asse{s/abOu{,DublicalIOns/ahs—pub—phase-1一report-edm-2030-plan.pdf
Edmonton Zone 2030 Plan http://www.aIbertaheaIthservIces.ca/abOut/Paae1 2823.aspx
Edmonton Zone 2030 Plan Phase 1 FinaI Report Summary http://www.albe rlaheal什1serv『ceS.ca/
assets/news/rlslne—rIs一2O14—12—02—2030一plan—edm—bkgr—final-report.pdf
Edmonton Zone Rehabilitation and Restorative Care http://www.clpna.com/wp-content/uploads/2016/01/
Carol-and-Penny—Think—Tank-201 5一presentation.pdf
·Independent Living Suite(GRH)
http://www.albertahealthservices.ca/grh/Pagel 4503.aspx
·moveEZ Program(GRH)
http://www.albertahealthservices.ca/news/releases/201 3/Page871 8.aspx
·Randomised Coffee Trials
Implementing Randomised Coffee TriaIs:The Communication PIan(Spa rk)一http://www.
s0arkc0lIabOrat1On.com/implementing—randomised—coffee—trials—communication—plan/
InslltutIona ng Serendipity via Productive Coffee Breaks(Nesta UK Innovation Foundation)http://
WWW.nesta.org.uk/blOg nsfllul10nalising—serendipity—productive—coffee—breaks
·
Reverse Trade Show(GRRIT)
Huge touchscreens make rehab a game for Glenrose patients(CBC News)http://www cbc.ca/news/
canada/edm0nfOn/huge—touchscreens—make—rehab—a—game—for—glenrose—patients一1.24271 56
·Senior Friendly Hospitals
AHS Seniors Health Strategic Clinical Network—http://www.albertahealthservices.ca/scns/Page77O2
aspx
Alberta Council on Aging—http://www.acaging.ca/
·World Health Organization(WHO)International Classification of Function(ICF)Mode
原文
lntroduction
The Glenrose Rehabilitation Hospital(GRH),Edmonton,Alberta,Canada,is an academic teaching
hospital within Alberta Health Services serving over 20,000 active patients annually and supported
by 1,500 plus physicians and staff and over 1,000 students,1 00 researchers and 400 volunteers.
The GRH is a recognized leader in providing specialized geriatrics and complex rehabilitation across
the age continuum.The 244 bed hospital sees 762 inpatients and provides 76,1 30 ambulatory
visits per year.The GRH has made signiifcant strides in advancing clinical research and has pio—
neered a variety of technology innovations that have directly improved the lives of older adults with
physical,cognitive,mental and social disabilities.In alignment with our Vision—Building Abilities for
Life ”and the World Health Organization ICF(International Classification of Functioning,Disability
and Health)model,these innovations are targeted at improving patient function and independence
based on patient/family needs while concurrently helping to grow confidence in social participation
and create opportunities for societal engagement and contribution.Functional independence has
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THEME REPoRT 038
also been supported by the advancement of a variety of home—·based monitoring and assistive technolo‘·
gies focused on safety,environmental controls,medication management and functional mobility that have
contributed significantly to older adults staying in their homes and within their communities.Established in
1 994,the Glenrose Rehabilitation Hospital Foundation exists solely to supped the enhancement of patient
care through innovative technology,state—of—the—art equipment,leading—edge research and valued patient
comforts at the Glenrose Rehabilitation Hospita1.Over the years,the Foundation's Board of Trustees have
been essential to advancing the unique role of the hospita1.The Friends of Glenrose is a group of volun—
teers who fundraise for patient care and comfort within the hospital and have been actively supposing the
hospital for over five decades.
Building Design Considerations—The GRH is situated on 1 3.6 acres and is comprised of four major build—
ings on the site:GlenWest,GlenEast,the Energy Centre and the Research Technology Centre.Unique
design features are profiled below.See also Appendix A and B.
GlenWest:The very compact and operationally effective square plan of GlenWest(opened in 1 990)con—
sists of four floors of superstructure with a floor of service and support in the basement.A tunnel sys—
tern links the GRH to two adjacent healthcare facilities on the campus.The iconic design of GlenWest has
played a key role in supposing the GRH to advance tertiary rehabilitation.(See Appendix B for architectur-
al images.)The organization of the four lfoors is as follows:
·Main floor reception,clinics cafeteria,and suppo ̄.Direct links to existing GlenEast functions
·Second floor:Administration,clinics and diagnostics
·Levels Three and Four:The driver of the plan and structure was the need for 208 inpatient beds over
two floors with 1 04 beds per floor.A critical issue in planning was the tight plan size and the need to build
inpatient floor support at Level 3.The design team proposed four internalized two—level atria to house key
functions within an optimal environment for patients and staff.The atria provide an abundance of natural
light to create an uplitfing and restorative environment for patients and staft.
One of the major plan strategies in the design of GlenWest was the need for good directional flow and
patient/visitor wayfinding.This was achieved by the large central elevator lobby with clear direct access
to the four nursing stations oi-I Levels Three and Four.This also assists staff in safety and security for pa—
tients.During construction,the top floor of 1 04 beds were functionally changed to accommodate geriatric
beds.A major departu ̄for the planning of the one—and two—bedroom inpatient rooms arose through a
series of planning workshops with operational staff.They stated that normal two—bedroom units consisted
of an entry,a bathroom and two beds divided by curtains.With the curtains drawn.the inner bed has no
direct access to daylight.The very groundbreaking plan the designers created was to alternate two—and
one—bed units with the two—bed units in the form of a diamond.This allows access to windows frOm each
bed,shared and accessible direction to the washroom and secured access for staft and visitors.Addition—
ally,with a focus on patient and staff safety,the toilet is spaced away fr0m the wall to allow a care provider
a left and right patient transfer.
GlenEast:GlenEast was completed in 1 973,complementing the original GRH which officially opened in
1 964.GlenEast houses the pediatric programs including 1 0 pediatric rehabilitation beds,26 inpatient
beds for Children and Adolescent Mental Health as wel las an array of ambulatory programs and the
Gtenrose Schoo1.Linking GlenEast and GlenWest are the Cafeteria(Bistro),the Aquatics Centre,the Gym—
nasium and the Dr.Bil IBlack Auditorium.
Glenrose Rehabilitation Research,Innovation and Technology Building:The Glenrose Rehabilitation Re—
search,Innovation and Technology Building,an historic building,is home to researchers and hosts a Rum—
039
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ber of fabs/conference rooms and staff/student Offices
GRH Energy Centre:The GRH Energy Centre provides steam and cooling to the Glenrose as well as to
two neighbouring healthcare facilities on the campus.
In 2008 a site master development plan and expansion for the entire site was completed.More recently
future plans for the GRH have been articulated in the 2030 Plan which was completed in 201 3.
Specific Interior Hospital Features:
·Common/Shared Areas(used by staff,physicians,patients,families,general public)(See Appendix A)
·Wi—Fi access for patients/families and Sta仟across the facility
Barrier Free Design/Infrastructure:
·Facility Access—covered patient drop—off areas at frOnt entrance and school bus entrance;street—level
entrance to Adult and Pediatric Admitting/Information;automatic double—wide doors in main entrance;
large,open foyers;easy—to—read navigation signage;accessible parking in underground parkade and des—
ignated surface stalls a ̄acent to hospital entrances
·Corridors/Hallways—wide.non—slip flooring;noise control via floor materials;non—glare lighting;murals
to guide activity;wall—mounted handrails diferent colour frOm walls;benches at various intervals to rest;
accommodation for larger mobility devices(electric wheelchairs,scooters,strollers,extra wide manual
wheelchairs)
·General decor and color to create comforting,non—threatening environment;use of brighter colours to
diferentiate;contrasting colours to delineate objects and levels and improve depth perception and ability
to judge distances
·Oversize Elevators—inpatient transportation;stair replacement dependent on disability;accommodates
transportation of inpatient food and medication carts;transportation of supplies and linens;emergency
stop and access
·Multiple hand—washing stations
·Designated weigh—scale access for morbidly obese outpatients and patients
·Bathrooms—wheelchair accessible,multiple bathrooms throughout hospital;unisex;accommodates
joint patient and caregiver access;grab bars;emergency alarm access;lower toilets in pediatric area for
children
·Specialized Areas—Hair Salon;wheelchair accessible sinks and salon chairs
·Welcoming/Stimulating Environment—art work on walls fcoordinated by Arts in Rehab Council);
age—appropriate wall graphics and paint colours in pediatrics;natural light via sky lights and large windows
throughout;views of outdoors.
·Disguised exit doors to discourage wandering for Dementia patients
Waiting and Patient/Family Sitting Areas:
·Age appropriate furn}ture:diferent chair heights and widths(obesity,arthritic conditions);uncrowded and
sufficient seating
·Adjacent or short walking distance to assessment and other clinics
Public Food Areas:
·Cravings Caf6一moveable tables and chairs to accommodate wheelchair users;intimate settings;wheel—
chair height tables;adjacent to third floor adult/older adult inpatient units;privacy via plants and other
greenery(See Appendix A)
·Bistro—wide distances between food access areas;wheelchair height self—serve counters;moveable
tables and chairs to accommodate intimate or large group settings;large spaces between tables for per-
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sons using mobility aids;wall photographs depicting clinical set—
tings;live TV broadcast capabilities;individual and group awards
showcased
·DentaI Clinic—wheeIchai r and stretcher accessibIe and is
equipped with overhead litfs for client transfers(including bariatric
patients)and large exam rooms to enable student learning and
family participation
Education/Conference Space:
·Sexual Health Service—wheelchair accessible.Iow examination
tables
·Radiology/Videofluroscopy—specialized equipment also available
for urodynamics and dysphagia assessment
·Cardiac Rehabilitation Pr0gram—wheelchair accessible;natural
light;specialized equipment appropriate to persons with a disability
and/or requiring cardiac rehabilitation
·Audiology Booths—multiple.sound—protected;wheelchair ac—
cessible,special lab for vestibular testing,cochlear implant assess—
ment/monitoring
·Dr.Bill Black Auditorium—wheelchair seating;tiered seating with
ramp access;VideOcOnference capabilities;accommodation for
bariatric patients
·Patient Library—access to general library services;computer-sup—
ported individual kiosks;numerous books/multimedia products on
disability available to patients/families
·Patient FamIly Resource Room—access to brochures,pamphlets,
infOrmation on community services
Staff Areas(used directly by staff or to support staff needs):
·Staff Lounge—for use during designated work breaks;informal
·Therapeutic Treatment Areas—large.open spaces;natural light;
age and disability—appropriate exercise areas and equipment;large
space for use of mobility aids;size of exercise beds and platforms
aligned to patient safety needs and transfer abilities;low mats;stor-
age for play—based therapeutic toys in pediatrics;access to refriger-
staff socialization;computer access(See Appendix A)
·Daycare—staff and general public;licensed and accredited child—
care program;accommodates 30 children and 8 staff(experienced
with children with special needs);space for morning and afternoon
snack and music program,access to developmentally appropriate
ators for pharmaceuticals(including for Spasticity Clinic);
swimming program for preschoolers,playground(See Appendix A1
·Staff Fitness Centre—Open 24 hours/7 days per week.Fitness
equipment,specialized classes;personal trainers available,show—
ers/change rooms,bicycle looks
Patient Care/Family Areas(primarily inpatient areas):
·Inpatient Rooms—generous accommodation;optimizes individual
privacy and dignity;select isolation rooms;potential for temporary
creation of homelike settings;grab bars and raised toilet seats in
bathrooms;patient lits;naturalf daylight;view of outdoors frOm ma—
Therapeutic/Treatment Areas(ambulatory clinics support thera—
peutic activities by rehab service providers e.g.Physical Therapy
,
jority of patient rooms,individual communication(White)boards ad—
jacent to bed(current care plan,any restrictions,mobilization and
therapy activities)(See Appendix A)
·Select Specialized Rooms—patient isolation;bariatric patients
Occupational Therapy,Communication Disorders,Recreation Ther-
apy,Audiology):
·Clinic Rooms—spacious meeting/patient assessment rooms with
smart board and telehealth technology
(1arger than normal rooms;heavy—duty furnishings;extra—large
bathroom openings;locked units with key pad access(brain lnju
dementia)
·Patient Dining Rooms—bright and cheery;movable seating and
·Gymnasium—large,open space to support fitness classes,team
sports(basketball,volleyball,wheelchair sports,wheelchair danc—
ing);specialized flooring to ml nImize injuries frOm falls
·Aquatic Centre—dual purpose public recreational and therapeutic
swimming.Features include,long wheelchair access ramp;sup—
port rails along ramp and steps;aquatic wheelchairs and stretch—
tables;supports individual or group dining(See Appendix A)
·Patient Lounges—change of environment;watch TV;connect
with friends and famiIy via social media;comfortable lounge chair
seating
ers;underwater parallel bars(removable);on—deck showers;safety
bars along pool edges;small water slide;assistive equipment
·Technology Centres—comprised of multiple satellite areas e.g.
·Laundry Facilities—adjacent to adult/older adult inpatient units
·Independent Living Suite—recently updated,home—like atmo—
sphere(transitional patient apartment incorporating formal bed—
room,kitchen,bathroom,living area);incorporates assistive and
communication—based technology focused on patient safety and
Building Trades of Alberta Courage Centre(BTACC),Courage in
Motion(CIM)Centre,ICAN Centre,Syncrude Centre for Motion and
Balance(SCMB),Simulation Centre,GRH Oilers Interactive Learn—
ing(OIL)Centre,featuring state—of—the—art digital,interactive and
electronic gaming activities,telehealth access throughout the facility
function(e.g.,voice—activated telephones,wearable patient alarm
systems accommodation of persons with no or limited vision or
hearing;incorporating innovative technology)
Specialized Clinic Spaces:
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Research and Technology Development:
·Rehabilitation Research Centre—small work areas to support development of technology—based tools
to improve patient function and independence e,g.gait disorders,spinal curvature;limb amputations and
3一D prosthetics;computer-based assistive technology;robotics,virtual reality,cognitive learning,larger
areas to test use of technology;graduate student space;common areas for joint problem—solving among
researchers
Specific Exterior Hospital Features:
·Exterior Landscaping—welcoming esthetic to patients/families and visitors through annual planting of
blooms that flower in spring,summer and fall;walk ways;patient gardening area,pathways for walking/
wheelchairs.Vegetable Garden on f 0nt lawn every summer—produce available for patients and local area
residents
·Playgrounds/Recreation Areas—equipment supports children with disabilities;children in Daycare;
separate recreational area/therapeutic terraces for adults/older adults(e.g.,walking,basketbal larea;
non—movable picnic tables with benches)(See Appendix A)
·Parking/Accessible Transportation—in addition to underground parking,three surface lots are available
for visitor/staff parking.Light rai ltransit and bus access is also available in close proximity to the hospital
Government/Policy Makers—The GRH has a longstanding reputation for collaborating with local,provincial
and national health and government sectors to influence policy around improving accessibility and living/
care environments for seniors.Here are some examples:
·Continuing Care Resolution Team(CCRT)一Created by Alberta Health Services(AHS)for clients and
families with unresolved concerns related to continuing care placement or care.The GRH was represent—
ed on the two—person team which worked closely with leaders in Continuing Care as wel las others in AHS
and in community partner organizations to resolve issues in public and privately—operated continuing care
facilities as well as those related to home care services.Based on feedback frOm over 1,000 clients/fam—
ilies,frontline staff,facility leadership,community stakeholders and academic,technology,business and
industry partners.1 7 recommendations were made to address concerns in six areas:access,transitions,
communications,facility,quality of care and others with work underway to make service improvements
based on the recommendations.
·A Place to Call Home—In 201 6 the GRH held a Provincial Symposium targeted at the presentation and
discussion of the 1 7 recommendations frOm the Alberta Health Services review of Continuing Care,with
continuing care defined to include individuals living in their own home,or a supportive living or long—term
care setting.Recommendations focused on the implementation of innovative and transformational care
models for special populations across the lifespan.such as the frail elderly and those with dementia,men—
tal health issues,brain inju spinal cord i nju multiple sclerosis,palliative/end—of—life care,persons with
developmental disabilities and autism.
·Age Friendly Edmonton 一GRH is a member of Age Friendly Edmonton .an initiative to build a city
that values,respects and actively supports the well—being of seniors.It is an inclusive place where seniors
are engaged,contribute to their communities,are safe and wel lin their homes,are respected and included
and have access to the programs,services,and resources they need.Co—led by the City of Edmonton
and the Edmonton Seniors Coordinating Council.Age Friendly Edmonton is a partnership of organiza—
tions committed to local action。The Glenrose Hospital has also contributed significantly to the Housing
sub group of Age Friendly Edmonton .and the creation of guidelines and a website for Home for Life .
The Home for Life guidelines outline essential accessibility features to build a residential home that wil l
support the needs of individuals through all ages and stages of life.
·Mayor ̄Roundtable on Accessible Housing for Seniors—Making our Houses Lifelong Homes—In 2009
the GRH in partnership with the former Mayor of the City of Edmonton(Stephen Mande1)convened a con—
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042
ference on accessibility targeted at the seniors’population.Innova—
tive research,resources and models related to accessible housing
for seniors were shared.An overview document was produced that
identified strategies to encourage and expand accessible housing
build international relationships.Examples of recent Trade Missions
include:
o Alberta Medical Devices Mission to China International Medical
Equipment Fair(CMEF)with focus on medical products(wearables,
electronics,first aid,diagnostics,and more)
o Alberta Technology Trade Mission to Mobile World Congress
options in Edmonton.This led to the development of Home for
Life rsee Age Friendly Edmonton above).
·Building Trades of Alberta Courage Centre—The Building Trades
(MWC)201 7 with a focus on mobile—related software,hardware,
healthcare,and more
of Alberta Courage Centre(BTACC)offers rehabilitation services
that use technology to assist people with physical and cognitive
problems.Some of the technology used includes:
o a vitruaI reality pod with hardware and software that enables pa—
tients to interact with vituaIr environments
·Military CAREN Design—The first of its kind in Western Canada,
the Computer—Assisted Rehabilitation Environment(CAREN),a
clinical virtual reality simulator,is making great strides in the rehabil—
itation of Glenrose patients of al lages as well as Canadian Forces
o an adapted driving simulator to train clients to learn to drive again
personnel presenting with both physical and psychological injuries.
The CAREN optimizes the rehabilitation experience and outcomes
in a fun,safe and physically and cognitively challenging ways.
·Senior Friendly Hospitals—Senior Friendly Hospitals are focused
on improving seniors’health,preventing their physical and men—
tal decline in hospital,optimizing their experience and outcomes
th rough committed leadership,caregiver processes and se—
nior—friendly physical spaces.
o a robotic—assisted gait trainer(Lokomat)to assist clients in learn—
ing to walk again
o a classroom with computers and a SMART board
o a pressure sensing mattress cover with continuous pressure im—
aging to assess risk of pressure injury
o technical support for innovative technology that shows promise
but is not widely used in rehabilitation
·Design for the Future—Clinical engineers are responsible for de—
signing new technology and coming up with creative solutions to
problems that no one else can solve,be it a life—saving medical de—
Canadian provinces of Ontario and Alberta are Canadian leaders in
the Senior Friendly Hospital concept with Ontario having developed
an evidence—based blueprint to guide hospital—wide improvements
in services for fraiI seniors.
vice or technology aimed at improving function and independence
for persons with disability.The GRH Rehabilitation Research,
Innovation and Technology Development Team is closely linked
with the Faculty of Engineering and Department of Biomedical
GRH received Alberta Council on Aging Senior Friendly desig—
nation in 2007.W_thin Alberta the Seniors Health Strategic Clinical
Network is advancing the Elder Friendly Hospital initiative to ad—
dress all the potential complications for seniors that happen in hos—
pitals.
Engineering,University of Alberta.Opportunities are continuously
created for engineering undergraduates and graduate students to
take on research roles,extra—curricular research projects and to be
exposed to the research and development side of technology de—
sign.Across the hospital many technology design initiatives have
been created including assistive technology to improve mobility and
functional independence for older adults.
·Edmonton Health City—Edmonton is a medical research power-
house in Canada and a pioneer within the healthcare industry.This
new strategy launched in 201 6 is focused on propelling Edmonton
as a world—class health innovation city by increasing access to
capital for local health sector companies,accelerating the com—
mercialization of new technologies and products and attracting and
retaining top talent,funding and partnerships.GRH is a key player
within the Health City initiative
·Spotlight on Research Breakfast—Each year the Glenrose Spot—
light on Research Breakfast raises awareness about the importance
of rehabilitation and the promise that research holds for the future.
The 1 1 th Annual event featured a keynote address by Dr.Eloy van
Hal,Consultant and Facility Manager,Dementia Village,De Hogew—
eyk,The Netherlands entitled,The De Hogeweyk Dementia Care
Revolution。A gated model village in The Netherlands has been
designed as a pioneering care facility for people with dementia
but the model has application to a number of special populations.
People live together with other people who share the same ideas
and values in life and manage their own households together with
a constant team of staff members.Just like any other village,it
has streets,gardens,parks and a selection of facilities including a
restaurant,grocery store,a bar and a theatre which are also acces—
sible to residents in the surrounding ne}ghbOurhO0ds.
·Hospital Planning:Edmonton Zone 2030 Planning for RAH/GRH/
Norwood Campus,Design consultation of Capital Care Norwood—
A comprehensive,long—term service and infrastructure plan for the
·Trade Missions—GRH regularly collaborates with TEC Edmonton
whose purpose is to accelerate growth of emerging technolo—
gY—based companies.Trade missions are one way to develop Ed—
monton's innovation reputation worldwide while providing valuable
opportunities to explore new markets,showcase technology,and
043 主题报道
THEME REPoRT
Edmonton area was developed to identify current and future health care needs for the region
The plan is
.
targeted at efficient allocation of resources,improvements in patient service outcomes
utilization of exist—
,
ing space and expanding where necessary,while planning for future growth and technology
A separate
.
initiative aligned to the 2030 Master Plan was focused on the development of a profile for rehabilitation and
restorative care services across the care continuum within the Edmonton area
The Glenrose participated
.
in the planning discussions for the Norwood facility which will include programs to address complex coR
—
tinuing care needs,sedation dentistry(important for specific patient populations)and post—acute sewices
which emphasize a restorative/reablement approach to care
.
。Partnering with our Stakeholders—The GRH believes in collaborating with partners
Collaboration is the
.
cornerstone of success in any team. Sharing of planning,making decisions
solving problems,setting
,
,
goals,assuming responsibility,working together cooperatively
communicating,and coordinating openly
are key contributors to improving project results and patient/family outcomes.
·Alberta Caregiver College@一Unpaid caregivers,such as spouses
family members or friends.are edu—
,
cated about the physical,emotional and psychological impacts of injury,illness and disability and how to
meet the needs of a family member.The material is designed to provide optimum care
provide informa—
,
tion on various resources,build caregiver confidence and self—reliance。and offer suggestions for develop—
ing strong networks in the community and with other caregivers.The educational programs were devel—
oped by Glenrose Hospital health professionals and physicians in collaboration with various Alberta Health
Services sites and community organizations and currently includes a course focused on providing family
caregivers with additional skills for enriching the quality of life of the older adult.Access to resources has
been enhanced for caregivers throughout Alberta through the use of telehealth and webcasting technolo—
gY.
·AHS Continuing Care Expo 201 6一This event was Alberta’s largest independent living and mobility show
bringing together consumers(including seniors,military personnel and Indigenous peoples),service provid—
ers,healthca ̄professionals,private organizations and retailers.It was a free event focused on supporting
Albertans with disabilities,special needs,care requirements or chronic conditions,and their families and
caregivers.Products and se ̄ices supporting independent and community living are showcased through
a variety of exhibits,learning opportunities,hands—on technologies and resources of special interest,in—
ctuding recreation,travel,finance and legal se ̄ices.
·Educating Emerging Health Care Practitioners—For over 50 years.the Glenrose Hospital has provided
opportunities to post—secondary university students to develop their clinical and technical skills in associa—
tion with academic programs.Annually,approximately 1,000 healthcare practitioners are educated in the
areas of Medicine and Dentistry,Nursing,Rehabilitation Medicine,Psychology,Engineering,Physical Ed—
ucation and Recreation,Pharmacy,Computing Science and Social Work.Glenrose Hospital patients and
staff have also benefitted frOm partnerships involving students enrolled in select university and technical
programs related to integrated inter-professional education and in completion of special projects involving
technology,computer systems,engineering and innovative product design.
·Glenrose moveEZ PrOgram—The moveEZ program,the only initiative of its kind in Western Canada,en—
gages university student volunteers to visit patients after hours and on weekends and encourages them
to move around as they share quality social time.Decline in mobility and deconditioning is a leading com—
plication of hospitalization for older patients.The hazards of immobility include loss of muscle mass and
strength.which increases the risk of falls;decreased lung volume;anxiety,depression
feelings of helpless—
,
ness;and loss of appetite.
‘Rehab Nursing Curriculum Design—The Glenrose Hospital Nursing Professional Practice Team provided
content expertise to the development of a Rehab Nursing Module on Reintegration into the Community
for inclusion in the Nursing Program education curriculum within the Faculty of Health and Community
Studies,MacEwan University,Edmonton,AB.The module is unique to standard nursing education and
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044
is focused on transition and discharge planning,restorative care,
community resources and adaptation to the client's environment.}t
is anticipated that this knowledge will support new nursing gradu—
ates to better integrate functional mobility and rehabilitation practic—
tract top minds frOm around the world.seek funding opportunities
and partnerships to better suppo ̄future research and develop
;nnovation Ieaders.
·Gerotechnology—Gerotechnology is as an emerging field that fo—
cuses on the development of instruments,devices,and ideas that
implement technology for the benefit of older adults and caregiv—
ers and is targeted at independent living,safe housing,and social
participation.Examples include safety monitors,fall prediction/
detectors,medication adherence detectors,power mobility,com—
munication and environmentaI aids.Within the GRH these devices
es into patienVfamily care regardless of their work environment.
·GRH Learning and Development Centre—The Glenrose Hospital
Learning and Development Centre offers a variety of workshops
and education and learning programs on site and online for staff
patients,families,and caregivers.Examples of program offerings
are:
o Alberta Caregiver College ̄
o Glenrose Hospital Leaders in Rehab:Mentoring Program for
Emerging Leaders
o Glenrose Annual Research Day
o Gtenrose Annual Research Day—Pediatrics
and aids are trialed within the ICAN Centre for Assistive Technology
and the Independent Living Suite to suppo ̄safe patient transition
back to their home and communities.
·Glenrose Hospital Independent Living Suite—The Independent
Living Suite(ILS)is a home—like setting available to al lGlenrose
Hospital patients and their families for assessment and therapeutic
activities focused on building abilities for patients to return home
safely.The suite also provides unique opportunities for incorporat—
ing innovative technology and research to improve the function of
seniors and persons with disabilities.often with support frOm indus—
try,business and the private sector.
o GRRIT(Glenrose Rehabilitation Research Innovation and Technol—
ogy1 Reverse Trade Show
o GRH/Covenant Health/Continuing Care Geriatric Psychiat ry
Conference
o Annual Alberta Brain Injury Network Forum on Outcomes Mea—
surement
o A Place to Cal lHome Symposium
·Academic Partnerships—The Glenrose Hospital has developed
and sustained strong clinical and research partnerships with the
academic community.Examples of partnership faculties and pro—
o Continuing Care and Community Living EXPO 201 6
o Greying Nation Conference
o Vestibular Assessment and Interpretation Across the Ages frOm
grams are:
o University of Alberta—Rehabilitation Medicine,Medicine and
Dentistry,Nursing,Engineering,Biomedical Engineering,Physical
Education and Recreation
o MacEwan University—Faculty of Health and Community Studies
Infant to Geriatric
o Leaders in Rehabilitation Conference
·Awards and Honours—Glenrose physicians,staff,researchers
and volunteers continue to be acknowledged for leadership,ex—
cellence in service delivery,innovation,technology development
and advancement of new knowledge.Over the years,Glenrose
physicians,staff and volunteers have been recipients of numerous
(Nursing,Therapy Assistant)
o Northern Alberta Institute of Technology一(Design and Communi—
cations,Computer Systems programs)
o Various Canadian and internationaI universities related to collab—
orative research and mutual interests—autism.scoliosis.bracing,
prestigious awards including the Canadian 3M Quality Award.the
Queen ̄Jubilee Medal,the Order of Canada,the City of Edmon—
ton Mayor’s Award,the Governor General’s Sovereign's Medal,
the Ronald Cape Distinguished Service Award by the Canadian
Geriatrics Society,the AHS President's Excellence Award for Distin—
guished Service,and most recently,Accreditation Canada's Stroke
Distinction Award 20 1 7.Last year,over 70 international visitors
toured the Glenrose to Iearn more about innovative rehabilitative
technology,specialized geriatrics and complex rehabilitative patient
and family care offered by the hospita1.
assistive technologies and technology innovation
·Randomized Rehab Coffee Trials(RRCT)一RRCT is a recent
Glenrose Hospital initiative and the first in the field of rehabilitation.
Originally developed in the UK by a not—·for-profit innovation founda··
tion,this initiative matches two people over a coffee or lunch break,
either face—to—face or via video,such as Skype or Facetime.The
goal is to build stronger social interactions and rehabilitation and
organizational networks while respecting the limitations on people's
time to“try and stay on top of everything”given the explosion of
Research and Innovation—The GRH highly values research and
innovation.The acquisition and integration of new knowledge and
technologies into rehabilitative care are critical to improved patient
outcomes.To this end the Glenrose has scaled up its ability to at—
technology and available knowledge.
·The Glenrose Hospital Leaders in Rehab:Mentoring PrOgram
for Emerging Leaders—This is a strategic effort to develop individ—
uals within the Hospital who have demonstrated commitment to
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their own professional development,who are interested in developing their leadership potential,skills and
knowledge,and who are keen to assume leadership roles.Partnerships with staff have expanded to in—
clude staff frOm acute care.1ong—ferm and continuing care and the Brain Care Centre Approximately 8—
1 0 staff graduate each year frOm the program.
·Glenrose Hospital Rehabilitation,Research,Innovation and Technology(GRRIT)一GRRIT is an initiative
that has put the Hospital at the forefront of healthcare innovation.Innovators and industry collaborate
on the development of technological solutions to address clinical problems,functional impairments and
improved care.Examples arising frOm collaborations include.assistive technologies.big screen touch
table to improve fine motor skills,glove to help patients grip objects,and a set of adjustable stairs to build
confidence and balance in stair climbing ability.An innovation that GRRIT has initiated is our reverse trade
shows where clinicians present wel ldefined problems to an audience of industry,academia and local in—
ventors to strategize on how best to grow capacity for science and technology commercialization.
·Partnership with Brenda Stratford Foundation—The Glenrose Hospital has established a partnership with
the Brenda Stratford Foundation via Dr.David Hogan,specialist in geriatric medicine,and his work in the
area of cognitive impairment/dementia.The foundation is focused on serving seniors and those in need
through investment in research on aging and funding for the Brenda Stratford Foundation Chairs in Geriat—
ric Medicine and jn AIzheimer Research.
Conclusion·-Seniors are our fastest growing population and they are living longer.The Glenrose Rehabil—
itation Hospital is committed to helping seniors with physical,cognitive or mental disabilities and chronic
conditions improve their function,independence and social participation.We have advanced caregiver
training,health professional education in specialized geriatrics and use innovative assistive and other tech—
nologies to improve the quality and better enable seniors to remain in their homes for as long as possible.
We do this with academic,industry,government and other health care partners.Working as a team has
permitted us to support municipal and provincial priorities at age—friendly housing,assistive technologies
and accessible services.The Glenrose Rehabilitation Hospital continuously scans the intemational care,
research and innovation markets to draw upon leading practices that will support functional independence
and quality of life for older adults.
Acknowledgements
I firstly would like to thank Community Design,for inviting me to be the contributing editor of this issue and
for the positive coordination in editing.I also would like to thank my team including the translator Yanting
Lin,the photographer Yuan Xu and the English editor Cindy Chopoidato,for their helpful support in deliv—
ering more completed materials to the publisher.Finally,1 would like to thank all institutions and individuals
who share their research and/or practice in this issue;they are(in no particular order):Isabel Henderson
and her group frOm Glenrose Rehabilitation Hospital;Dr,Megan Strickfaden fr0m the University of Alberta;
Mei Lan Fang and her group frOm Simon Fraser University and relevant institutions;Ron Wickman from
Ron Wickman Architect;WestView Health Center—Stony Plain;Greg Christenson and Christenson Devel—。
opment;Points West Living;Lifestyle Options Retirement Communities;and NorQuest College.
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