G313 Five year review of a hospital @ home service: Early discharge and improved patient experience. (27th April 2016) - Evans, EA
Abstract : Aims: Hospital @ Home (H@Home) was established as a virtual ward of the children's hospital with the aim of delivering high quality care in the home, facilitating discharge, and reducing the length of admission. Care is delivered by a team of five nurses who visit a child up to 3 times a day and is overseen by a senior nurse and consultant. Children are identified as suitable for H@Home by acute service teams and a daily ward round is undertaken with a consultant to ensure robust ongoing care. The service has been operational for 5 years and has evolved significantly to develop nursing skills and enhance retention, respond to bed pressures, and cater for children with a variety of medical needs. Methods: Activity and patient experience data has been analysed to evaluate the position of the service after 5 years. Results: Over 12 months, 477 patients were admitted to H@Home resulting in 1450 bed days being released. 72% (347/477) patients were from general paediatrics. Other sources were medical and surgical specialties. The majority of admissions (66%) were for intravenous antibiotic administration but the service accommodates other patients, for instance ACTH in infantile spasms. Re-attendance rates are low (49/447), the majority being for intravenous access. Patient feedback has been very positive and recent data has demonstrated that 92% would be likely or extremely likely to recommend the service to friends and family. No patients would choose to remain in hospital rather than being admitted to H@Home after using the service. They valued the benefits to the child, to siblings, and an earlier return to work. Areas for ongoing improvement include cannulation at home, training ward nurses to facilitate expansion during winter pressures, and microbiology ward rounds to identify suitable patients. Conclusion: H@Home has become an important part of delivery of paediatric care in the children's hospital. The care delivered is highly rated by families, effectively facilitating early discharge and improving patient experience. Over 5 years, the service has expanded and continues to develop, playing a vital role in increasing bed capacity.