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DELAYED DISCHARGE – AN NHS PERSPECTIVE. RIETA VILAR JOINT FUTURE PLANNING MANAGER. 11 June 2007. WHAT IS A DELAYED DISCHARGE?.

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DELAYED DISCHARGE – AN NHS PERSPECTIVE

RIETA VILAR

JOINT FUTURE PLANNING MANAGER

11 June 2007


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WHAT IS A DELAYED DISCHARGE?

  • ‘A DELAYED DISCHARGE IS EXPERIENCED BY AN INPATIENT OCCUPYING A BED IN A HOSPITAL WHO IS CLINICALLY READY TO MOVE ON TO THE NEXT STAGE OF CARE BUT IS PREVENTED FROM DOING SO BY ONE OR MORE REASONS FOR DELAY IN DISCHARGE’

  • READY FOR DISCHARGE DATE IS DETERMINED BY THE CONSULTANT OR GP RESPONSIBLE FOR THE INPATIENT CARE IN CONSULTATION WITH ALL AGENCIES INVOLVED IN PLANNING THE PATIENT’S DISCHARGE BOTH NHS AND NON NHS.


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A LITTLE BIT OF HISTORY:

  • IN SCOTLAND AS MUCH AS 10% OF HOSPITAL BEDS BLOCKED

  • FIRST PUBLISHED CENSUS SEPTEMBER 2000

  • OCT 2001 – WELL OVER 3000 PATIENTS DELAYED

  • BY 2002 THIS WAS REDUCED TO BELOW 2000

  • APRIL 2006 – 498 BEDS BLOCKED (OVER 6 WEEKS)

  • APRIL 2007 – DOWN TO 233 (OVER 6 WEEKS)


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IN GRAMPIAN:

  • ALMOST 400 BEDS WERE BLOCKED (2001)

  • NOW REDUCED TO JUST UNDER 100

  • APRIL 2006 – 78 DELAYED DISCHARGES OVER 6 WEEKS

  • APRIL 2007 – 33 DELAYED DISCHARGES OVER 6 WEEKS


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TARGETS SET BY SCOTTISH EXECUTIVE:

BY APRIL 2008 NO PATIENT WAITING LONGER THAN 6 WEEKS IN HOSPITAL

AND

NO PATIENTS WAITING IN AN ACUTE BED (3 DAYS)


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REASONS FOR THE 6 WEEKS:

  • DISCHARGE IS COMPLICATED

  • WILL TAKE TIME TO PUT SERVICES IN

  • SAFE DISCHARGE


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REASONS FOR DELAY:

  • LACK OF VACANCIES IN CARE HOMES

  • NO CAPACITY IN WOODEND OR COMMUNITY HOSPITAL

  • LACK OF HOME CARERS TO SUPPORT PEOPLE

  • LEGAL/FINANCIAL ISSUES

  • FAMILY DISPUTES




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IMPORTANCE OF INVOLVINGUSERS AND CARERS IN THEDISCHARGE PROCESS


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DELAYED DISCHARGES IS A MAJOR ISSUE

  • BEDS ARE REQUIRED FOR PEOPLE WITH MEDICAL NEEDS

  • HOSPITAL IS NOT A GOOD PLACE FOR PEOPLE TO BE ESPECIALLY TRUE FOR OLDER PEOPLE

  • INSTITUTIONALISED VERY QUICKLY

  • HOSPITAL ACQUIRED INFECTIONS


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WHAT ARE WE CONCENTRATING ON TO BRING DELAYED DISCHARGES DOWN TO ZERO?

  • PREVENTION OF ADMISSION

  • DEVELOP MORE STEP UP/DOWN FACILITIES

  • DISCHARGE PLANNING TO START ON ADMISSION (OR EVEN BEFORE ADMISSION IF ELECTIVE)


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RESEARCH QUESTION DOWN TO ZERO?

  • EFFECT ON PATIENTS/CARERS OF IMPLEMENTING THE CHOICE POLICY


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