Limited clinical support within care homes
As is common across England, lack of support to detect and manage residents’ health issues results in high utilization of emergency services. 1,2
Imperial College Healthcare NHS Trust Case Study
Case Study
Supporting care homes during a pandemic
How Imperial College Healthcare NHS Trust’s Frailty Team supported care homes to minimize ED attendances and hospitalizations.
Imperial College Healthcare NHS Trust at a glance
Imperial College Healthcare NHS Trust provides acute and specialist healthcare in northwest London for around 1.5 million people every year.
The trust’s care home liaison team, known as the Frailty Team, works directly with 26 care homes within the region to provide support, education, and expertise to staff to ensure their residents are kept safe, well, and out of hospital.
Challenges
In 2020, it was Imperial’s imperative to minimize avoidable hospitalization of frailty patients in order to protect them from the life-threatening coronavirus.
Lack of contextual data during patient assessment
ED assessment is challenging due to patients’ multiple interacting comorbidities. As a result, 70% of patients are admitted, staying for an average of 6 days. 3
Frailty patient vulnerability to coronavirus
Hospital transfer carries an increased risk of COVID-19 exposure, which is potentially life-threatening to this patient group.
Solution
The Frailty Team used Current Health to minimize care home resident ED attendance and hospitalizations, thus reducing the potential exposure to COVID-19.
Vital sign capture from residents
Current Health’s monitoring kits were supplied to 9 care homes and used to monitor the health of residents of concern.
Clinical insight and remote assessment
The team completed remote assessments to understand symptoms and other important information not made obvious through the vitals data.
Informed decision making
Collectively, this insight helped the team to make informed decisions about resident care so timely intervention could be delivered.
Full Results
With access to Current Health, the Frailty Team was able to take the following interventions to avoid ED admissions:
Residents not admitted to the ED due to ability to intervene remotely
Decrease in overall care compared with inpatient stay
Potential bed days saved due to avoided ED attendance
Patient adherence wearing Current Health device
An estimated £62.5k in cost savings in the first 3 months
1. Health Foundation and Nuffield Trust Research (2015) Quality Watch: Focus on hospital admissions from care homes. London, The Health Foundation.
2. The Health Foundation Improvement Analytics Unit Report (2019) Emergency admissions from hospital form care homes: how often and what for? London, The Health Foundation.
3. Imperial College Healthcare NHS Trust Frailty Service data
4. British Geriatrics Society Good Practice Guide (2020) COVID-19: Managing the COVID-19 pandemic in care homes for older people, version 3. London, British Geriatrics Society.
5. https://improvement.nhs.uk/resources/reference-costs/
*Based on 6 day average length of stay 5.