DoC - Brian Slater presentation
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Day of Care Learning workshop 24th September 2019
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DoC - Brian Slater presentation
- 1. REDUCING HOSPITAL USAGE BY BETTER COLLABORATION BETWEEN ACUTE AND COMMUNITY
- 5. Proportion of delayed discharges by reason for delay; Scotland; Average number across censuses April 2018 - March 2019
- 7. Standard delays over three days duration
- 9. Delayed discharge bed days as a proportion of all occupied bed days by NHS health board of treatment; Scotland; 2018/19
- 10. Delays as a part of occupied bed days
- 11. Mr A’s experience of being delayed in hospital
- 13. Rate of hospitalisation – over 65s 0.0% 0.4% 0.8% 1.2% 1.6% 2.0% Aberdeenshire Moray Clackmannans… Argyll&Bute Stirling Highland Dumfries&… OrkneyIslands Perth&Kinross ScottishBorders Angus Falkirk ShetlandIslands EastAyrshire Fife WestLothian NorthAyrshire North… East… East… AberdeenCity EastLothian SouthAyrshire South… Midlothian DundeeCity Renfrewshire EileanSiar West… Cityof… Inverclyde GlasgowCity Proportionof65+population
- 14. Rate of hospitalisation – over 65s 0.0% 0.4% 0.8% 1.2% 1.6% 2.0% Aberdeenshire Moray Clackmannans… Argyll&Bute Stirling Highland Dumfries&… OrkneyIslands Perth&Kinross ScottishBorders Angus Falkirk ShetlandIslands EastAyrshire Fife WestLothian NorthAyrshire North… East… East… AberdeenCity EastLothian SouthAyrshire South… Midlothian DundeeCity Renfrewshire EileanSiar West… Cityof… Inverclyde GlasgowCity Proportionof65+population
- 15. A single version of the truth We often flag patients as medically fit for discharge when they are not, because we know that planning only starts when they are flagged. Nurse We spot patients that aren’t medically fit on the list – hospitals are trying to shift the responsibility. Discharge Hub
- 18. Delayed Discharge Expert Group Report (2011)
- 22. Partnership visits – key themes • Strong leadership • with staff empowered to make decisions – and take risks • Initiatives rolled out ward by ward to instil staff confidence in changes • Early referral to / involvement of social work, with • Multi-disciplinary discharge hubs, ideally including housing and carer support, • Discharge huddles • A Home First focus • Involving the Third Sector e.g. Red Cross schemes Assessment at home / home from hospital services • GP involvement • Clear, single referral pathways for all Intermediate Care services • Back home boxes • Dedicated Mental Health Officer to reduce length and number of AWI delays
- 23. Hearts and Minds
- 25. Reflections • It is about outcomes, but people often want to talk about process. • It is about behaviours. • Everyone wants change, but it is easier when other people have to do it. • There are some really hard-edged challenges where it has to work quickly, but change takes time.