Search results for ‘Subject term:"older people"’ Sort:
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Improving length of stay: what can hospitals do?
- Authors:
- LEWIS Ruth, EDWARDS Nigel
- Publisher:
- Nuffield Trust
- Publication year:
- 2015
- Pagination:
- 27
- Place of publication:
- London
Drawing evidence from the literature together with insights from a number of case studies and a number of senior clinicians and managers, this paper explores what approaches to reducing hospital length of stay have been, and could be, effective. Case study hospitals and much of the literature emphasise the importance of focusing on approaches to improve patient flow through the hospital post-admission and developing a culture of proactive patient management. The following approaches were highlighted as having a positive impact on improving flow and length of stay: senior leadership and decision-making early in a patient’s journey through the hospital; reduce patient moves; tracking patient progress through the hospital; proactive multidisciplinary patient management embedded through rounds; seven-day rounds and supporting services; and planning for discharge. In particular, establishing discharge coordinators to progress transfers and establishing positive working relationships with health and social care partners across the week has been found to be effective in improving patient flow in case study hospitals. (Edited publisher abstract)
How older people cope with frailty within the context of transition care in Australia: implications for improving service delivery
- Authors:
- WALKER Ruth, JOHNS Julie, HALLIDAY Dianne
- Journal article citation:
- Health and Social Care in the Community, 23(2), 2015, pp.216-224.
- Publisher:
- Wiley
Transition care is increasingly common for older people, yet little is known about the subjective experience of the transition care ‘journey’ from the perspective of clients themselves. This study examines how older people cope with frailty within the context of a dedicated transition care programme and discusses implications for improving service delivery. Qualitative in-depth interviews were carried out during 2011 in the homes of 20 older people who had recently been discharged from a transition care programme operating in Adelaide, South Australia (average age 80 years, 65% female). Thematic analysis identified three key themes: ‘a new definition of recovery’, ‘complexities of control’ and ‘the disempowering system’. Despite describing many positive aspects of the programme, including meeting personal milestones and a renewed sense of independence, participants recognised that they were unlikely to regain their previous level of functioning. For some, this was exacerbated by lacking control over the transition care process while adapting to their new level of frailty. Overall, this research highlighted that benefits associated with transition care can be undermined by fragmentation in service delivery, loss of control and uncertainties around future support. (Publisher abstract)
Moving healthcare closer to home: case study: Enhanced Rapid Response Service: Kent Community Health NHS Foundation Trust
- Author:
- MONITOR
- Publisher:
- Monitor
- Publication year:
- 2015
- Pagination:
- 4
- Place of publication:
- London
This is one of a suite of case studies designed to increase awareness of schemes to move healthcare closer to home. The Enhanced Rapid Response Service (ERRS) helps patients in crisis avoid a stay in an acute hospital where clinically appropriate. After initial clinical triage, the service assesses the patient in their own home where medical, nursing and therapy support is then given. Important features of the service include leadership by the consultant geriatrician, who manages a team of specialty doctors and enhanced practitioners, and an engagement programme with primary care, the mental health trust, social care and the ambulance trust to boost uptake of the service. (Edited publisher abstract)
Moving healthcare closer to home: summary
- Author:
- MONITOR
- Publisher:
- Monitor
- Publication year:
- 2015
- Pagination:
- 12
- Place of publication:
- London
Summarises the findings of a project examining examples where provision of non-elective care moved from an acute hospital to the community. The Five Year Forward View has encouraged efforts to deliver more healthcare out of acute hospitals and closer to home, with the aim of providing better care for patients, cutting the number of unplanned bed days in hospitals and reducing net costs. Drawing on the lessons from a set of case studies, this analysis shows that: well-designed schemes to move healthcare closer to home can deliver benefits in the long term; it is difficult, however, to cut costs across a local health economy in the short run; and better data and improved pricing would help. The paper is part of a suite of materials developed to support providers and commissioners making decisions about schemes to move healthcare currently provided in acute hospitals to community-based settings. (Edited publisher abstract)
Helping them home: supporting hospital discharge in Scotland
- Author:
- ROYAL VOLUNTARY SERVICE
- Publisher:
- Royal Voluntary Service
- Publication year:
- 2015
- Pagination:
- 12
- Place of publication:
- Cardiff
Examines how practical and person centred support, focused on social interaction and provided by volunteers, can help people feel better about their discharge from hospital, improving wellbeing and recovery. In particular, the document looks at the Royal Voluntary Service Home from Hospital service, which places a caring volunteer at the centre of an older person’s recovery plan, with the aim to: support and engage with patients on ward during the recovery phase to identify personalised outcomes for discharge; provide practical help and support following a discharge from hospital; help users regain confidence and reduce anxiety; reduce social isolation; promote independent living and choice; help users maintain day to day activities; provide information/signpost to other organisations; and help prevent readmissions to hospital. The document explains how the service works in hospital, at home and in the community, and the steps to set up a Home from Hospital service. It includes case studies and examples of services. (Edited publisher abstract)
Safely home: what happens when people leave hospital and care settings?
- Author:
- HEALTHWATCH ENGLAND
- Publisher:
- Healthwatch England
- Publication year:
- 2015
- Pagination:
- 59
- Place of publication:
- London
Presents the findings from an inquiry into the emotional and physical impact of hospital discharge. With the help of 101 local Healthwatch, the enquiry panel heard from over 3,000 people who shared their stories about their experiences of the discharge process, focusing in particular on older people, homeless people, and people with mental health conditions. The findings reveal that there are five core reasons people feel their departure is not handled properly: people are experiencing delays and a lack of co-ordination between different services; they are feeling left without the services and support they need after discharge; they feel stigmatised and discriminated against and that they are not treated with appropriate respect because of their conditions and circumstances; they feel they are not involved in decisions about their care or given the information they need; and they feel that their full range of needs is not considered. The report includes examples of good practice and initiatives and projects designed to help older people, homeless people, and people with mental health conditions resolve the difficulties they experience during the discharge process. (Edited publisher abstract)
Help them home report: the challenges facing families of older people
- Author:
- ROYAL VOLUNTARY SERVICE
- Publisher:
- Royal Voluntary Service
- Publication year:
- 2015
- Pagination:
- 28
- Place of publication:
- Cardiff
This report explores the experiences of families of older patients during and after discharge from hospital and the support that is available to them. The report begins by reviewing the current health and social care context, with a focus on delayed discharges and the availability of social care. It then looks at key findings from an earlier report by the Royal Voluntary Service, 'Going Home Alone', which suggested that hospital readmission was closely related to whether individuals receive the support they need when discharged. Based on a sample of 1,000 adults in England, Scotland and Wales whose older parents had been discharged following a significant inpatient hospital stay, the report then looks at families' experiences and views of hospital care, available care and support at home, and how they would manage in the future. Results of the analysis found that: almost a third (30%) of respondents felt their family support network was not strong enough to cope without external help after hospital discharge; a quarter had concerns about the care received by their parent after post-discharge; and one in five of our respondents felt that discharge was too early. The report makes recommendations and identifies six key factors to ensure older people have a better experience of hospital discharge and that they have adequate support when they return home. (Edited publisher abstract)
Understanding and improving older people's experiences of service transitions: implications for social work
- Authors:
- TANNER Denise, GLASBY Jon, McIVER Shirley
- Journal article citation:
- British Journal of Social Work, 45(7), 2015, pp.2056-2071.
- Publisher:
- Oxford University Press
This paper examines the concept of transition and its centrality to later life experiences. It considers how an enhanced and more user-centred understanding of transitions can be harnessed to improve older people's experiences of moving into and between health and social care services. It focuses, in particular, on the neglected dimension of subjective experiences of transition and considers how social workers can engage with older people's emotional responses at times of change to improve their experience of transition processes and outcomes. (Publisher abstract)
Moving healthcare closer to home: case study: Older People’s Assessment and Liaison (OPAL) Service: Gloucestershire Hospitals NHS Foundation Trust
- Author:
- MONITOR
- Publisher:
- Monitor
- Publication year:
- 2015
- Pagination:
- 4
- Place of publication:
- London
This is one of a suite of case studies designed to increase awareness of schemes to move healthcare closer to home. The Older People’s Assessment and Liaison (OPAL) Service at Gloucestershire Hospitals NHS Foundation Trust ensures that older people presenting at the trust’s A&E receive comprehensive clinical assessment and care planning from a consultant geriatrician. An important feature is the OPAL consultants’ close working with the integrated discharge team to facilitate supported discharge and recovery at home. (Edited publisher abstract)
Moving healthcare closer to home: financial impacts
- Author:
- MONITOR
- Publisher:
- Monitor
- Publication year:
- 2015
- Pagination:
- 40
- Place of publication:
- London
This paper is part of a suite of materials developed to support providers and commissioners who are making decisions about schemes to move care currently provided in acute hospitals to community-based settings. The paper presents key findings on the costs of delivering care through these schemes, compared to delivering care in an acute setting. To make the comparison, the study has modelled the potential effect on cost expenditure of four established types of scheme that deliver healthcare closer to home: telehealth schemes; enhanced step-up schemes; rapid response and early supported discharge schemes; and reablement services. The findings relate to a typical suburban local health economy over five years. The four types of scheme aim either to divert acutely unwell patients from being admitted into an acute hospital, to speed up their discharge or to reduce their ongoing care needs. Key findings include: in the long run, the costs of delivering care in the community may be lower than those of delivering care in acute hospitals; movements in cost and demand mean schemes are likely to be more important for avoiding future costs than for yielding immediate savings; these schemes are one important tool in the wider toolkit for addressing hospital financial and operational challenges; and the schemes will still need to be well designed to be cost-effective. (Edited publisher abstract)