Transcript Hi Jo this is the half way summary poster

Stroke Care
Title: Bournemouth Community Stroke Early Supported Discharge Team
Title of improvement:
NEW Stroke Early Supported Discharge Service
What was the challenge/problem:
Prior to the pilot commencing, patients who were admitted to RBCH acute stroke services did
not have access to a Stroke ESD Service. National metrics, including the Accelerated Stroke
Improvement Measures include i) presence of stroke skilled Early Supported Discharge (ESD)
Team and ii) proportion of patients supported by a stroke skilled ESD. The models used for
providing Stroke ESD vary widely, and whilst there had been much debate locally about the
most effective way forward, it was not easy to accurately assess the exact local need and most
effective model of provision. Furthermore, changes to the in-patient stroke pathway, including
a planned reduction of 20 inpatient stroke beds, meant that Stroke ESD would be integral to
ensuring a seamless flow across the stroke pathway.
What was done/solution:
A 6 month pilot Stroke ESD Service commenced at RBCH on 1st August 2011. The pilot was
funded jointly between the acute Trust and Bournemouth and Poole PCT. By running a pilot
service, it was possible to:
a)
b)
test many of the assumptions made in the main business case, and
evaluate the impact of Stroke ESD on inpatient and community services in order to
inform future planning
The Stroke Early Supported Discharge Stroke is just one aspect of the delivery of stroke
specialist community rehabilitation. The service aims to provide rehabilitation and support to
people who have had a stroke with residual mild to moderate disability, to allow for completion
of recovery and rehabilitation at home at an earlier stage. In order to run the pilot, stroke
specialist staff were seconded from the inpatient stroke service – these positions were
backfilled using the pilot monies.
Contact Details
Name:
Louise Johnson
The NEW Royal Bournemouth &
Christchurch Hospitals Stroke
Early Supported Discharge
Team
Job Title:
Clinical Lead – Stroke
ESD
Organisation:
Royal Bournemouth and
Christchurch Hospitals
NHS Foundation Trust
E-mail:
Louise.Johnson@wesse
xdeanery.nhs.uk
Date: November 2011
Stroke Care
Title: Bournemouth Community Stroke Early Supported Discharge Team
What was achieved?
The pilot is now reaching the half way point. The key achievements to date
are:
•
72 patients have been supported by the Stroke ESD Team in the first three
months of the service becoming operational
•
It is estimated that a total of 686 bed days have been saved
•
In-patient stroke beds have reduced from 56 to 32
•
All patients have maintained or improved their level of function
•
100% of patients report being satisfied or very satisfied with the service
What resources were used and what savings may be expected
from the changes?
• A full financial report for costs and predicted cost savings is currently being
prepared as part of the business case for the on-going provision of ESD
beyond the pilot period.
Time taken to implement:
• The pilot will run over a 6 month period (August 2011 to January 2012)
• During this time, the service is being constantly evaluated, with a formal
3 month review
• There will be an independent 6 month review carried out by the Wessex
HIEC
Lessons Learned/Barriers & Risks:
The concept of ESD challenges historical ways of working. As a service, we
have therefore had to be:
Brave and resilient
Confident in our abilities,
experience and skills –
transferring these into
the community setting
Very flexible,
dynamic and
innovative
The Stroke ESD Service aims to integrate fully with existing intermediate and
social care services. It therefore needs to interact with a number of
organisations. This has been challenging, but the team is able to demonstrate
successful integrated working with various intermediate care services and
work around this is on-going.
How does the improvement benefit
patients/carers/staff/organisation?
Improved
outcomes for
patients by
receiving
specialist
rehabilitation
in an
environment
that is
meaningful and
relevant to
them
A seamless
transfer of care
from hospital
and onwards to
community
services
including social
care and
voluntary
services
High levels of
job satisfaction
among Stroke
ESD staff
members
Clear reduction
in in-patient
length of stay
which has
facilitated an inpatient bed
reduction