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Admission avoidance and patient turn around at the front door Hot

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Area Classification

Acute / Hospital Care

Briefly describe what it is

A team based within the Emergency Department, screening all medical GP referrals with a view to prevention of admission to hospital by utilising community support or alternate medical pathways.
The Team also assists ED staff with providing urgent community support for patients who do not require admission for medical reasons, working within the 4 hour target.
The team also work across the Medical Admissions Unit preventing unnecessary admissions to the acute wards and commencing early discharge planning with the aim of reducing length of stay. The team consists of senior nurses & mixed skilled rehabilitation and care management assistants.

Were there any key things that you had to do to make it happen?

The success required joint partnership working between local PCT and Acute Trust initially for pilot and also to continue service provision.
Engagement of local GPs, care providers and Acute Trust staff across all specialities
Support from Trust Boards both Acute and Primary Care

Describe (and provide evidence) of the impact on quality of care

Data collected shows 4% of medical referrals do not require hospital admission and have been turned around by the team providing a better quality service.
Patients within the ED receive rapid assessment of discharge needs resulting in provision of appropriate follow on care and support.
Patients given rapid quality advice/support.

Describe (and provide evidence) of the impact on patient (or staff) experience

Patients not admitted to acute ward unless medically required.
Better discharge planning on admission results in reduced length of stay.
ED staff released from discharge planning (as now carried out by specialist team) leaving them free to care for medically unwell patients.
Patients receive early specialist support, better patient experience

Describe (and provide evidence) of the impact on reducing cost

Initial report following pilot showed savings in region of £160k pa for PCT plus with the reduction in bed days a potential saving of £25k pa for the Acute Trust.
Effective use of Trust beds preventing cancellations of electives.

Keywords / Tags

prevention of admission/ reduced length of stay/ discharge planning

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