The success of implementing the 72 hour discharge target project is now being replicated across the city. The project also serves as a model for other local authorities and NHS Boards.
Analysis has shown that;
- people have been identified appropriately for intermediate care,
- identified earlier and discharged from hospital earlier
- avoiding any unnecessary delays for the individuals
- ensuring they receive every opportunity to enhance their rehabilitation journey and
- increased numbers returning to their own home and
- increased numbers moving on to residential care rather than nursing home care.
Performance data highlights that as at as at 5 January 2015, 63 people over 65 years (excluding Mental Health/Learning Disability/Adults With Incapacity), were delayed in acute hospital care with an average delay of 23 days. By 4 Jan 2016, 17 patients were delayed in hospital for an average of 13 days. This represents a 73% reduction in the number of patients delayed.
In December 2014 the total acute bed days lost in Glasgow City was 2897, by December 2015 this has reduced to 1566, a 46% reduction in the number of bed days lost.
Areas of service weakness were highlighted through comparison of sector analysis across the three areas. Following detailed discussions action plans were put in place to address these. This analysis led to improved sharing of information, the reduction of a high number of performance reports into one comprehensive report and improved quality of information on individual service users via the use of an agreed risk assessment tool.
Better targeting of Social Work resources was also achieved by linking social workers to hospitals, with tighter management and named rehabilitation workers.
Evidence of cultural change and improved joint working practices is reflected in regular multi-disciplinary team meetings and positive staff feedback in evaluation forms from stakeholder events. A practitioners group has been established to ensure robust engagement with GPs and hospital consultants and is working well.
Recognising the impact of this work, the Scottish Government has often used Glasgow as an example of outstanding practice. The most recent demonstration of this was in December 2015 when the Health Secretary Shona Robinson noting that “the figures in Glasgow are impressive. Over the last 12 months, there have been significant and sustained reductions in the number of people delayed in hospital because they are waiting for the appropriate care and support in the community. Hospital bed days lost have halved, far fewer elderly patients in Glasgow are waiting in hospital and we’ve seen a big shift towards discharging people within three days.”
Introducing 72 hour discharge is an innovative approach compared to national targets. We implemented it first from 1 December 2014 in North East Sector, followed by North West and South from 1 February. This was well ahead of the Scottish Government target of 14 days from 1 April 2015.
A Scottish Care Accolade Award was awarded to one of the care providers for its innovative working as part in the intermediate care project.