Our Services The second of our three service delivery groups, the Hospital then Home Group, provides inpatient care for patients who need us to look after them in hospital because their illness means they can be safely cared for only in a hospital setting. All of these patients will have first made contact with us through the first of our three service delivery groups.
Service Delivery Group 2 Hospital then Home
The goal of this Group is to treat and support patients according to their needs. This Group is responsible for elderly medicine, neurology, rheumatology, general medicine, rehabilitation medicine, pharmacy, therapy services as well as intensive and high dependency adult care. This group currently manages wards 1, 2, 3, 5, 6, 7, 9, 10 and 16 (ICU/HDU) as well as HODU. However, it is expected that Ward 9 will join our third service delivery group, Elective Care, as 15 bed Elective Orthopaedics.
Launching the new Elderly Consultant of the Fortnight In August 2005 the four consultants in elderly medicine made radical changes to the way the service for the over 80s is provided. Instead of a GP asking a bed manager to admit a patient for an opinion and treatment, the GP speaks directly to the duty consultant, weekdays 10am - 6pm. Accident and mergency staff have access to the same system. The consultant has a clinic each morning at 10.00 and so a patient can always be seen within 24 hours. This means a goodly number of patients do not have to come in to hospital with all the disruption that entails, often upsetting routines, bringing on confusion and risking infections. But the patient still gets a consultant opinion, and fast. Service departments have been fantastic
in supporting this initiative – for example - same day CT scanning allows a ‘one stop shop’ approach to assessing a patient.
The target we were given was a 10% reduction in emergency admissions, and we have more than reached that target.
Advice to the GP can resolve the problem, or at least get the patient on the right track. A home visit by the consultant is also available. The feedback from GPs has been very positive, so after the first 4 months the scheme was extended to include urgent out patient referrals, not just an alternative to admission.
Education & training have been built in to the development. Trainee GPs have particularly valued the easy access to the consultant.
Sometimes another specialty is involved immediately, reducing delays and transfers. The number of patients who get the right solution without being admitted varies from week to week but has been between 4% and 20% of those initially referred for admission.
Consultants from Airedale Hospital Dr Mary Harrington and Dr Aduke Onafowokan who were involved in the pilot and design of this will be extending the hours a consultant is available for advice to midnight as there is feeling that the out of hours GP service needs this kind of support when seeing unfamiliar elderly patients in the evenings at home.
New Medicines Code Earlier this year staff signed up to a new Medicines Code as part of the Trust’s plans to ensure all staff are up to date with their knowledge on medicines handling. All wards and clinical departments have received copies of the new Code aimed at ensuring that staff who have responsibility for handling medicines, whether it be transporting, prescribing or giving the medicines, are aware of the rules. The Trust first created the Medicines Code in 2004 in order to put together all the rules governing medicines management in one
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easily accessible place. This new Medicines Code goes one step further and provides easy to follow guidance for the full range of staff who deal with medicines. As well as doctors and nurses there are more and more health professionals who are handling medicines such as radiographers and physiotherapists and as this role extends so there is more need to clear guidance on which staff can access which medicines. In the future the Trust is planning a Passport to Prescribe where staff develop a clearly documented series of skills with stringent accountability and training.
The Pharmacy Department has also started a medication discharge project and formed a Medicines Management Link Group, to improve the use of medicines