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Results for 'hospital discharge'

Results 1 - 10 of 19

Reducing falls in older adults recently discharged from hospital: a systematic review and meta-analysis

NASERI Chiara, et al
2018

Background: older adults are known to have increased falls rates and functional decline following hospital discharge, with substantial economic healthcare costs. This systematic review aimed to synthesise the evidence for effective falls prevention interventions in older adults recently discharged from hospital. Methods: literature searches of six databases of quantitative studies conducted from 1990 to June 2017, reporting falls outcomes of falls prevention interventions for community-dwelling older adults discharged from hospital were included. Study quality was assessed using a standardised JBI critical appraisal tool (MAStARI) and data pooled using Rev-Man Review Manager® Results: sixteen studies (total sample size N = 3,290, from eight countries, mean age 77) comprising 12 interventions met inclusion criteria. Findings: home hazard modification interventions delivered to those with a previous falls history (1 study), was effective in reducing the number of falls (RR 0.63, 95%CI 0.43, 0.93, Low GRADE evidence). Home exercise interventions (3 studies) significantly increased the proportion of fallers (OR 1.74, 95%CI 1.17, 2.60, Moderate GRADE evidence), and did not significantly reduce falls rate (RR 1.27, 95%CI 0.99, 1.62, Very Low GRADE evidence) or falls injury rate (RR 1.16, 95%CI, 0.83,1.63, Low GRADE evidence). Nutritional supplementation for malnourished older adults (1 study) significantly reduced the proportion of fallers (HR 0.41, 95% CI 0.19, 0.86, Low GRADE evidence). Conclusion: the recommended falls prevention interventions for older adults recently discharged from hospital are to provide home hazard minimisation particularly if they have a recent previous falls history and consider nutritional supplementation if they are malnourished.

Comprehensive care: older people living with frailty in hospitals

NIHR DISSEMINATION CENTRE
2017

This review looks at the concept of 'frailty' in older people and what can be done to raise awareness amongst hospital staff, so that they can better identify and manage the needs of this ‘frail’ older people. It features 53 completed and ongoing studies funded by the National Institute of Health Research. The review covers four key aspects of caring for older people living with frailty in hospital: assessment; identifying and managing symptoms associated with frailty in hospital; discharge planning; and caring environments which consider the context in which inpatient diagnosis and treatment is delivered. The review highlights promising evaluations of workplace training and interventions. It also identifies a number of tools, such as the Frailty Index, that can help hospital staff to identify the severity of needs and help to provide targeted support. It also finds good evidence that the Comprehensive Geriatric Assessment (CGA) is a reliable way of diagnosing and meeting the needs of older people with input from multi-disciplinary teams. It also identifies areas where more research is needed, which include: maintaining activities of daily living for people admitted to hospital; and the effectiveness and cost-effectiveness of different models of delivering care. The review also includes a series of questions that hospital boards, staff and families can ask about the care of older people with frailty in hospitals. Summaries of the 53 studies are also included.

The Lightbulb project: switched on to integration in Leicestershire

MORAN Alison
2017

A case study of the Lightbulb project, which brings together County and District Councils and other partners in Leicestershire to help people stay in their homes for as long as possible. The approach includes GPs and other health and care professionals and relies on early at home assessment process at key points of entry. This is delivered through a ‘hub and spoke’ model with an integrated Locality Lightbulb Team in each District Council area and covers: minor adaptations and equipment; DFGs; wider housing support needs (warmth, energy, home security); housing related health and wellbeing (AT, falls prevention); planning for the future (housing options); and housing related advice, information, and signposting. The Lightbulb service also includes a cost effective specialist Hospital Housing Enabler Team based in acute and mental health hospital settings across Leicestershire. The team work directly with patients and hospital staff to identify and resolve housing issues that are a potential barrier to hospital discharge and also provide low level support to assist with the move home from hospital to help prevent readmissions.

The role of housing in effective hospital discharge

SKILLS FOR CARE, CHARTERED INSTITUTE OF HOUSING
2017

A collection of case studies from a wide range of housing providers, highlighting the role they can play in developing hospital discharge services. The case studies demonstrate the development of effective partnerships to meet hospital discharge needs, how these partnerships can help meet partners’ targets, and the workforce skills required to ensure effective services. Key learning points from the case studies include recognising and understanding different working cultures; building lasting relationships; effective and safe communication of information between agencies; developing sustainable and long term provision; and building a person centred solution. The publication will be particularly useful for social care and health commissioners, providers of housing and support and workforce development leads.

Reducing delayed transfer of care through housing interventions: evidence of impact. Case study

ADAMS Sue
2016

A case study and independent evaluation of a housing intervention designed to help older patients to return home from hospital more rapidly and safety. The initiative is delivered by West of England Care & Repair (WE C&R), who organise clutter clearance/deep cleaning; urgent home repairs, emergency heating repairs and essential housing adaptations for older people in hospital. The evaluation examined all case records, interviewed 15 hospital staff and undertook an in depth analysis of a sample of 4 cases. Analysis of the case records estimated a saving in hospital bed days of £13,526. The cost of housing interventions was £948, resulting in a cost benefit ratio of 14:1. Additional savings in hospital staff time amounted to a further £897. A short case study illustrates how the service was able to help one woman return home from hospital. It concludes that the small scale evaluation is indicative of the potential savings that a practical and effective home from hospital housing intervention service can generate for the health service.

Integrated care for older people with frailty: innovative approaches in practice

ROYAL COLLEGE OF GENERAL PRACTITIONERS, BRITISH GERIATRICS SOCIETY
2016

Joint report showing how GPs and geriatricians are collaborating to design innovative schemes to improve the provision of integrated care for older people with frailty. The report highlights 13 case studies from across the UK which show what an integrated health and social care system looks like in practice and the positive impact it can have. The case studies are grouped into three areas: schemes to help older people remain active and independent, extending primary and community support to provide better services in the community, and integrated care to support patients in hospital. The examples cover a range of locations across the UK, including urban and rural populations, and a range of settings, including services based in the community, in GP practices, in care homes and in hospitals. Whilst the majority of the initiatives led by GPs or geriatricians, they illustrate the vital role that many other professionals play, including nurses, therapists, pharmacists and social workers. The report also outlines some common themes from the case studies, which include person-centred care, multidisciplinary working, taking a proactive approach and making use of resources in the community.

Quick guide: supporting patients' choices to avoid long hospital stays

NHS ENGLAND, et al
2016

This quick guide provides practical advice to help local health and social care systems reduce the time people spend in hospital when they no longer need acute care, but are delayed whilst making decisions about or making arrangements for their ongoing care. The guide covers: providing people with information about their choices after hospital discharge, providing support to allow patients to make choices about their ongoing care, the availability of care homes and care packages at home, a patients refusal to leave hospital, and use of interim packages and placements. Each section includes a checklist of actions to consider to help identify areas for improvement and examples of practical solutions to common problems, including links to useful resources. A template policy and template patient letters that can be customised and used locally are also included.

Quick guide: health and housing

NHS ENGLAND
2016

This is one of a series of quick, online guides providing practical tips and case studies to support health and care systems. It provides practical resources and information for Clinical Commissioning Groups (CCGs) from a range of national and local organisations on how housing and health can work together to prevent and reduce hospital admissions, length of stay, delayed discharge, readmission rates and ultimately improve outcomes. Specifically, the guide describes: how housing can help prevent people from being admitted to hospital – by enabling access to home interventions (social prescribing), improving affordable warm homes (safe, warm housing), improving suitability and accessibility, and providing housing support; how housing can help people be discharged from hospital – through coordination of services, provision of step down services, and accessible housing design; and how housing can support people to remain independent in the community – by enabling informed decisions about home and housing options, providing assistive technology and community equipment, supporting social inclusion, providing supported housing, and promoting healthy lifestyles.

Harnessing social action to support older people: evaluating the Reducing Winter Pressures Fund

GEORGHIOU Theo, et al
2016

Presents the findings of an evaluation of seven social action projects funded by the Cabinet Office, NHS England, Monitor, NHS Trust Development Authority and the Association of Directors of Adult Social Services. The aim of the Reducing Winter Pressures Fund was to scale up and test projects that used volunteers to support older people to stay well, manage health conditions or recover after illness, and thereby reduce pressure on hospitals. The organisations supported by the fund comprised a range of national and local charities. These projects fell into three broad categories: community-based support, supporting discharge from hospital wards, and supporting individuals in A&E department to avoid admissions. Between them, the projects offered a wide range of services to older people – both direct (for example help with shopping or providing transport) and indirect (linking with other services). The evaluation resulted in a mixed set of findings. From the interviews with staff, volunteers and local stakeholders, there was evidence of services that had made an impact by providing practical help, reassurance and connection with other services that could reduce isolation and enable independence. Those involved with the projects felt that volunteers and project staff could offer more time to users than pressurised statutory sector staff, which enabled a fuller understanding of a person’s needs while also freeing up staff time. However, the analysis of hospital activity data in the months that followed people's referral into the projects did not suggest that these schemes impacted on the use of NHS services in the way that was assumed, with no evidence of a reduction in emergency hospital admissions, or in costs of hospital care following referral to the social action projects. The one exception was the project based in an A&E department, which revealed a smaller number of admissions in the short term. The report questions whether these sorts of interventions can ever be fully captured solely using hospital-based data and conceptualising reduced or shortened admissions as a key marker of success.

Making it happen: take action to get people with a learning disability, autism and/or challenging behaviour out of inpatient units. A guide for campaigners about Transforming Care Partnerships

MENCAP, CHALLENGING BEHAVIOUR FOUNDATION, NATIONAL AUTISTIC SOCIETY
2016

Guide to help local groups and individuals campaign for change to enable people with a learning disability, autism and/or challenging behaviour to move from inpatient units into the community. The guide highlights NHS England's promise in 'Building the Right Support' to close 35-50 per cent of inpatient beds and develop the right support in the communities by March 2019. It sets out the scale of the challenge and outlines the role of the 48 Transforming Care Partnerships, set up to implement NHS England's plans. The guide then provides advice on how campaigning groups and individuals can contact local Transforming Care Partnerships to find out more about their plans and find out what is being done to develop the right support. It includes a template letter to help contact local Partnerships; a checklist of key principles that should be included in Transforming Care Partnership plans; and a list organisations that can provide further support.

Results 1 - 10 of 19

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