HomeIn and Out of Hospital

In and Out of Hospital

The British Red Cross is in an ideal position to not only observe the fabulous work which is being undertaken within the health and social care services, but also the pressures the system is under.  They have now produced an excellent  report based on their research, which outlines the strain the system is under; and makes recommendations for reducing admissions – particularly readmissions.

Over the last five years emergency hospital admissions have risen by 22.8%, with the number of readmissions within 48 hours accounting for 20% of these.  Unfortunately, it would appear that hospitals are not always aware of the patients who are being re-admitted several times.  The report suggests that simple measures such as checking a patient’s mobility, assessing the home for trip hazards, or seeking a patient’s perception of how safe they feel in their own home, may prevent many of these readmissions.

Conversely, a lack of care within the community is often resulting in people being stuck in hospital.  It is estimated that for each day in hospital, an older person loses up to 5% of their muscle strength, which impacts on their ability to live safely and independently at home.

This report makes a number of recommendations based on the understanding of these issues from the perspectives of both the professionals and patients.

Recommendations:

Helping people feel safe at home

  • Identify, and put in place an automatic home assessment process for people with frequent readmissions
  • Government seed funding should be made available to establish proactive falls prevention services to ensure people have access to the mobility aids and the simple home adaptions which would allow them to live independently in their own home.
  • Patients admitted with falls who have poor mobility, and live alone, should automatically receive a home trip hazard assessment

Avoiding unnecessary hospital admission

  • Invest in non-clinical personnel within A&E to support people who are medically safe but need support to remain within their own home. Such support should include accompanying the person home safely.
  • Ensure all appropriate patients are referred to multidisciplinary teams that hold regular meetings to discuss the ongoing needs of the patient and have shared access to care records.

Helping people home from hospital

  • The discharge process must include an assessment of medication and equipment needs which should be arranged before the patient is discharged.
  • All patients living alone with reduced mobility should be offered transport home from hospital. This should include assistance into the house, offering an opportunity to check the home environment.
  • Ensure frail patients who are in hospital whilst awaiting a community care package, are encouraged and assisted to get dressed and walk around every day to reduce muscle strength wastage.

The British Red Cross acknowledge that the health and social care system is under tremendous pressure, a lot of which is underpinned by a lack of resources.  However, they believe that the recommendations above could make a big difference to both patients and patient flow.

To read the full report from the British Red Cross please click here.