At Christiana Care Health System, high-quality, personalized care for older patients reflects our organization’s core values of Excellence and Love. A cornerstone of care is WISH, a NICHE Exemplar program since 2015, led by Denise L. Lyons, DNP, APRN, AGCNS-BC, and Patricia M. Curtin, M.D., FACP, CMD.

What is WISH?

The We Improve Senior Health (WISH) program is a collaborative effort to improve the care that Christiana Care delivers to older adults. WISH was derived from a national initiative called Nurses Improving Care to Health System Elders (NICHE).

Denise L. Lyons, DNP, APRN, AGCNS-BC

NICHE was developed by New York University’s Division of Nursing and the Education Development Center for Health Care Practice and is funded by The Atlantic Philanthropies, U.S. Ageing Programme. NICHE is the premiere international geriatric nursing program that addresses the needs of hospitalized older adults.

There are more than 670 NICHE-designated sites across 47 states and five countries. The NICHE network collaborates with more than 20,000 health care providers on geriatric issues. Christiana Care has been a NICHE member since 2001.

Who’s on the WISH team?

The key to implementing WISH was developing the Senior Health Resource Team (SHRT), with interprofessional health care providers committed to improving geriatric care at Christiana Care. To become a SHRT member, these professionals attend a course in specialized geriatric training. They also serve as unit-based resources to address the diverse problems of older adults on patient care units. In the last 18 years, the WISH Program has trained over 3,000 SHRT members systemwide.

What are the requirements for Exemplar status?

Since 2015, Christiana Care has earned annual Exemplar status — the highest of four possible program levels — by undergoing a rigorous self-evaluation survey. The award covers Christiana Care’s guiding principles, organizational structures, leadership, geriatric staff competence, interdisciplinary resources, environment of care, quality measures and patient- and family-centered care. Exemplar status requirements include:

  • Implementation of the SHRT model and evidence-based protocols on all applicable units, including specialty units.
  • Implementation of systemic aging-sensitive policies.
  • Inclusion of the input of patient, families and staff in planning and implementation of initiatives.
  • Assuming regional and national leadership roles.

How are Excellence and Love reflected in the care seniors receive?

Our care for seniors is centered on nationally recognized evidence-based practices. Our SHRT members are committed and passionate about providing expert, respectful care to older adults.

The WISH program is a collaborative effort among nursing, physicians, pharmacists, rehabilitative therapists, social workers and other disciplines to improve the care for hospitalized older adults. WISH was designed to engage members in cultivating a new way of thinking about caring for older adults. The objectives of the program include:

  • Providing organizational structures that will assist in the development of a senior-friendly health care organization.
  • Focusing on preventing and managing common geriatric syndromes such as delirium, depression, adverse drug reactions, pressure ulcers, functional decline and bowel/bladder dysfunction.
  • Ensuring that health care providers use WISH principles and evidence-based guidelines regarding common elder health concerns such as delirium, constipation, continence, pressure ulcer prevention, sleep promotion and fall prevention.

What role do loved ones play in care?

We focus on the patient and that often involves partnering with family members and other loved ones to ensure our senior patients experience the best quality of life possible. We can help them to improve the care they are receiving at home, help in administering medications and creating a safe environment at home. We also connect them with community resources that can help to make their lives healthier, happier and safer.