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Making Communication Matter –

Making Communication Matter – Improving communication between Hospital and Care Home Jane Ewen, Nutrition Champion, NHS Grampian. Tara Hargreaves, Nutrition Champion, NHS Lothian. Alison Molyneux, Care Home Services Dietitian, NHSGG &C. 9 th June 2011. Aim of Session.

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Making Communication Matter –

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  1. Making Communication Matter – Improving communication between Hospital and Care HomeJane Ewen, Nutrition Champion, NHS Grampian.Tara Hargreaves, Nutrition Champion, NHS Lothian.Alison Molyneux, Care Home Services Dietitian, NHSGG &C. 9th June 2011

  2. Aim of Session • To share pilot work from 3 Boards to improve nutritional care communication between hospital and care home through the use of a nutritional care communication tool.

  3. Learning Outcomes • Outline the rationale behind the improvement. • Discuss the Nutritional Care Communication tool and its role. • Examine the findings from the pilot work undertaken. • Outline future national recommendations.

  4. IMPROVING NUTRITIONAL CARE PROGRAMME 18-month programme Supporting self-management of nutritional care for people with LTC Improving meal processes: improving intake/reducing waste Preventing re-admission due to malnutrition Managing transitions between hospital and care home to avoid malnutrition Ensuring people get the support they need to eat and drink

  5. Background • 13,000 discharges from hospital to care home in Scotland per annum (ISD). • 37% of people admitted to hospital from care home at risk of malnutrition. • Variation in communication between hospital and care homes re: nutritional care. • 43% sometime include, 7% did not/don’t know (BAPEN, 2010).

  6. What was tested and where To improve nutritional care communication in 95% of people admitted / discharged between hospital and care home in pilot sites by end May 2011. % compliance of people admitted / discharge to hospital/ Care Home per week V number of completed tools. % compliance accurately completed forms Establish if the tool improves communication. Establish if the tool allows staff to plan and address a persons ongoing nutritional care.

  7. The Tool

  8. Graph (1): Population Sample = (63)

  9. Graph (2):Nutritional Screening – MUST Score documented

  10. Graph (3)

  11. Graph 4: Specialised/ Therapeutic diets including Texture Modified Diets

  12. Graph 5: Assistance with Eating and Drinking

  13. Challenges Compliance Patient flow in hospitals Care Home emergencies Bank / Agency staff Local communication

  14. What’s working well? Immediate visual assessment Minimal time to complete Using more widely – District Nursing Team, Transfer to England Care Home Reduction in number of telephone calls Highlights the need that individual people require eg: prompting, cutting up etc. Prompting call from care home to hospital re: more info on prescribed nutritional supplement. Promotes continuity of care Relationships and rapport

  15. What the users say……… • “Able to plan from the beginning as this lady has dementia” • “I didn’t have to go searching for information, everything was at a glance” • “Should have happened a long time ago” • “ A lot of people don’t consider people need help with prompting and cutting up, this section is helpful”. • “Able to plan from the beginning”. • “Good information to support care and catering staff” • “MUST particularly helpful and means we have a baseline” • “Saves phoning and repeat phoning …” • “When can I get my hands on it!”

  16. “This is a new lady and the information that came with her allowed me to speak to our nurse that deals with nutrition screening and diets straight away. She was really pleased with it as normally we would just have information about why the person was in hospital and would have to find out ourselves through observation and asking the person if able, or family for more info. This can mean that it may be a week later or a few days at the very least. We were able to refer to deal with her needs straight away and refer her to our dietitian asap”. Care Home staff, Grampian, April 2011

  17. Recommendations Spread Plan with current boards and wider Education phase 1 to embed practice ie: Nutritional Screening. Communication tool and elements within Centralise information – Nutritional Care Website Consider tool in respect of Anticipatory Care planning Record keeping and hospital admission documentation

  18. Care Homes: Fairview, Aberdeen. Grandholm, Aberdeen. Kingsmead, Aberdeen. Wyndford Locks, Glasgow. Greenfield Park,Glasgow. Cluny Lodge, Edinburgh. Hospital Sites: City Hospital, Aberdeen. Aberdeen Royal Infirmary. Blowarthill Hospital, Glasgow. Lightburn Hospital, Glasgow. Corstorphine Hospital, Edinburgh. Acknowledgements Healthcare Improvement Scotland

  19. Questions

  20. References British Dietetic Association(2011) Dysphagia Diet Food Texture Descriptors. Royal College of Speech andLanguage Therapists, Hospital Caterers association and National Nurses Nutrition group Care Commission (2009) Eating well in care homes for older people. Care Commission. BAPEN (2009) Combating Malnutrition Recommendations for Action. Executive summary. Redditch, British Association of Parenteral and Enteral Nutrition (BAPEN) NHS Quality Improvement Scotland (QIS) (2003) Food, fluid and nutritional care in hospitals. Edinburgh, NHS QIS Scottish Government (2010) The Healthcare Quality Strategy for NHS Scotland. Crown Scottish Government (2011) Living and Dying Well Building on Progress. Crown Scottish Government (2010) Scottish Inpatient Patient Experience Survey 2010, Vol. 1: National Results. Crown Scottish Government (2007) National Care Standards care homes for older people. Crown

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