Transcript Document
Metabolic Medicine Salford Royal Hospital AQUA PROJECT TEAM Dr. Chris Hendriksz (Consultant) Lorraine Thompson (Clinic Nurse Specialist/Team Manager) Briony McNelly (Learning Disability Nurse) What successes have you had to date? • Manchester children’s hospital- 3 weekly transition clinic • Transition team – Doctor, Clinical Nurse Specialist, LD nurse, Physio and dietician • Bradford has started, 2 monthly – Doctor, nurse, dietitian (2 clinics so far) • Liverpool- in development (to be 2 monthly) • 1:1 consultation with nurse and patient in Manchester & Bradford (away from parents!) • Same day appointment at SRFT • Transition passport – Ready, steady, go What have been your challenges and how have you addressed these? • Lack of input from paediatric team Meeting in March 2015 • Weekly clinics & Small numbers booked into clinics – Reduce frequency of clinics • Patient DNA – Discharged patients or Refer to adult team • Transition passport, engagement of patients – patient held to professional driven.Kept in patients notes, nurses to complete. RSG. New Bradford clinic update • There have been 2 transition clinics carried out so far in Bradford, there is only one room allocated to the clinic, as there is no space, so nurse hasn’t been able to see the patient 1:1 without parents. The team are altogether in one big room. Format is usually doctor review, both paediatric and adult dietician review, then nurse introduces adult our service etc. • Expected to be 25 patients this year for transition from Bradford. Patients with learning disabilities Questionnaire not in easy read format – Variable results . Patient Story The patient attended transition clinic on two occasions, this was at the children’s hospital and on both occasions his family were both heavily involved in the consultation and he spoke very little. On the same day of his second appointment he attended the transition clinic in the morning with dad and again spoke very little with simple yes and no answers. That same afternoon he came across to the adult service and was seen by the adult team who directed all questions to the patient and encouraged him to respond, he was much more confident and answered the questions with full answers. A shared decision making approach was used. It was suggested by his consultant that he needs to have a 5 day heart test and due to the distance he would need to travel that he might be better doing this locally, as he would need to collect it and return it after 5 days. The patient suggested that he would have it done at Salford travel down on public transport with his dad and then return the tape by himself a week later. He wanted to know how he could get to the hospital by himself and we discussed the options with him, train, bus, taxi etc. He then started to discuss that he is looking to move out of his parents’ house and into an adapted house. We also discussed the fact that he is applying for a provisional license and wants to learn how to drive. We will encourage him at his next appointment to be seen on his own for part of the consultant. The change in him was remarkable and we hope that this continues as time goes on. Patient improvement suggestions • Transition document – To be made smaller, adapted. • Positive comments about the same day appointment – Being offered to all patients despite complexity What are your next steps? • Develop an agenda setting tool to give out prior to the appointment • To meet with the children’s team to engage them more in the process • Define 1 model for the Northern Network -i.e. Manchester/Bradford & Liverpool