PRISMA: a new model of integrated service delivery for the frail older people in Canada

PURPOSE PRISMA is an innovative co-ordination-type Integrated Service Delivery System developed to improve continuity and increase the efficacy and efficiency of services, especially for older and disabled populations. DESCRIPTION The mechanisms and tools developed and implemented by PRISMA include: (1) co-ordination between decision-makers and managers, (2) a single entry point, (3) a case management process, (4) individualised service plans, (5) a single assessment instrument based on the clients' functional autonomy, and (6) a computerised clinical chart for communicating between institutions for client monitoring purposes. PRELIMINARY RESULTS The efficacy of this model has been tested in a pilot project that showed a decreased incidence of functional decline, a decreased burden for caregivers and a smaller proportion of older people wishing to be institutionalised. CONCLUSION The on-going implementation and effectiveness study will show evidence of its real value and its impact on clienteles and cost.