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Digital Care Home

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Digital Care Home

• Developed by Durham Dales Federation ( DDHF) and CDDFT working group;

• 3rd iteration in continuous improvement cycle (NEWS – MIST – SBAR);

• Builds on evidence supplied by Vanguard care home project;

• Incorporates essential observations as well as contextual information;

• Generating 45% reduction of visits for DDHF;

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NHS care team activates SBAR e-referral task.

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The platform automates the co-ordination of monitoring with care home staff

N3-hosted digital health platform

Patient’s GP recordGP Federation

Hospital SystemsDurham Dales Model

Single point of Access

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Resident’s personal care

record

Personal digital health record for

each resident

GP Health Record

Each resident has a personal, digital health record which is linked to their GP record

Care home resident

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Tuesday, 21 March 2017

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The new SBAR tool including NEWS2

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The relevant clinical team pick up the reading, review and then action as appropriate. The patient’s GP record is also updated.

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Outcomes from Durham Dales HC Care Home 2017 2018

Month No of Residents No of VAWAS Visits No of Residents No of VAWAS Visits % difference

August 24 64 32 53 -17

September 24 57 24 42 -26

October 23 51 23 30 -41

November 42 78 40 70 -11

December 30 46 30 42 -8

January 36 61 36 49 -19

Total357 286 -20

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0

1

2

3

4

5

6

7

8

Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec Jan

2017 2018 2019

The Manor House In Hours Admissions

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Active participation

• Overwhelming positive feedback and support from the Federation;

• Care homes feel better supported and engaged with the clinical teams in the design;

• Nursing teams have seen a huge improvement of the quality of information and are continuously evolving the system through engagement with project group;

• Local authority are engaged and actively supporting the development with resources and funds;

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Care home feedback

Practice pre Health call was quite stressful in navigating through telephone systems, relying on messages / information being put through to the DN / ANP service was inconsistent and often problematic. Time was consumed making frequent phone calls between specific hours which were quite regimented and restrictive. This was also more difficult if a resident became unwell or required intervention in the afternoon as requests for that day had already been submitted and they had to wait until the following day.

I love the system, it has really improved the service provided within the home. Staff who weren’t as confident with technology advised that although they were unsure initially, once the Tablet / System process was demonstrated and used a few times, this was easy to use and navigate. It was also raised that the response from the DN / ANP appeared much quicker and was responsive to requests than previously.

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Care home feedback

▪ Greater flexibility to respond to the changing needs of residents.

▪ Regular baseline monitoring to assist in detecting any changes to resident’s conditions.

▪ More effective communication with DN / ANP.

▪ Reducing any calls that may not have been necessary and assistance to prioritise any individuals.

▪ Manager reports a 13% reduction in call outs.

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Lessons learned

▪ Training for clinical obs and technology to be undertaken separately

▪ Training carried out by the nursing team is valuable

▪ Care home staff more anxious about the technology than taking the observations

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Next steps

• Continued deployment in care homes across the county, to include nursing homes.

• Use the baseline observations to set personal thresholds for residents

• Feed into the regional National Early Warning Score (NEWS2) work to determine escalation pathway in the community

• Continue with the evaluation

• Health Watch to undertake independent qualitative evaluation

▪ Allow night staff to submit information for district nurse visits the next day

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Thank you

For further information:

Catherine McShane

catherinemcshane@nhs.net

07717480208

www.nhshealthcall.co.uk