care in crisis - the challenge carol herity – head of partnerships
TRANSCRIPT
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Care in Crisis - the challenge
Carol Herity – Head of Partnerships
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Our challenge:
“To identify what further support the Third and Not for Profit sector can offer to reduce delayed discharges.”
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Scope:
• Delayed transfers of care
• Multi-disciplinary Team decision that the
patient is ready for discharge/transfer
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Whole system support is needed…
• Acute & Community hospitals
• Intermediate Care Beds
• Clinical Commissioning Groups Enhanced
Assessment Beds
• Local Authority residential placements
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Underlying principles:• Coordinated inter-organisational approach• In-reach model• Early identification of patient needs• Continuity of responsibility for delivery• Daily review of progress and discharge plan
update• Discharges up to 8.00pm x 7 days per week• Value for money• Agreed evaluation criteria• Sustainability
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Benefits
• Increase in the number of patients referred to Third and Not for Profit Sector support each day
• Increase in the number of patients discharged each day with this support
• Daily update of the number of patients MDT fit for discharge flagged as needing the sectors support (waiting list)
• Daily update of the total number of occupied bed days since the patient was flagged as MDT fit for discharge awaiting this support
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Outcomes
A reduction in:• Numbers of Medically Fit For Discharge in
any setting• Patients length of stay• Readmissions
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How will we know it is working
• Review of any patients readmitted as an emergency / attending ED following discharge with Third Sector support v readmissions / ED attendances of patients not receiving Third Sector support– Within 48 hours– Within 7 days– Within 30 days
• Review of any patients readmitted as an emergency / attending ED following cessation of this timed support
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Thank you
Questions?