60 Front Door Specialist Frailty MDT Working at MFT NHS Trust—The Therapy Team Poster Presentation

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
H Turner ◽  
G Bennett ◽  
S Hurst
Keyword(s):  
Social Services ◽  
Local Community ◽  
Hospital Admissions ◽  
Discharge Planning ◽  
Community Services ◽  
Early Therapy ◽  
Therapy Assessment ◽  
Comprehensive Therapy ◽  
The Hours ◽  
Therapy Team

Abstract Introduction The therapy team consists of physiotherapists, Occupational therapists and therapy technicians working generically to deliver a comprehensive therapy assessment to patients presenting in our Emergency Department, Clinical Decisions Unit and Medical Admissions Unit between the hours of 08:00–18:00 7 days a week. The therapists provide the hospitals frailty service in ED and MAU with early therapy assessment and intervention, supporting the provision of a Comprehensive Geriatric Assessment. The aims of our service are to provide early therapy assessment of our most vulnerable patients to avoid unnecessary hospital admissions and reduce readmission rates, and for those requiring hospital care to provide early mobilisation and discharge planning to reduce length of stay and complications associated with hospital admission. We provide the therapy component of the CGA as part of the specialist frailty MDT service and act as an interface with local community health and social services. Method A full review of our frailty MDT service was undertaken and a re-allocation of our resources and staff was piloted in July 2019. During this pilot our therapy staff presence was re-distributed allowing greater patient numbers to be assessed promptly on their arrival to ED. This adjustment supported the Frailty MDT actions of: Results Data collection showed total referrals to therapy increased from 67 (June 2019) to 160 (July 2019). In July same day discharges were at 43%; discharges ≥72 hours 24%; 7 day readmission at 9%; 28 day readmissions at 11% and 38% were referred to community services. Conclusion These changes enabled us to provide a full MDT frailty service to frail older people presenting at our ED in a timely manner and to a larger number of suitable patients.

scholarly journals Tread Softly (UK, 1985, 51 mins)

1986 ◽  
Vol 10 (10) ◽  
pp. 293
Author(s):  
Elizabeth Garrett
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Social Services ◽  
Local Community ◽  
Psychiatric Hospitals ◽  
Community Services ◽  
Important Distinction ◽  
Training Material ◽  
Health And Social Services ◽  
Educational Films

ESCATA, the enterprising and innovative organisation which specialises in training material for health and social services professionals, does not claim mainly to produce educational films but rather, what it terms ‘video assisted workshops’. This is an important distinction and should be borne in mind when viewing the ‘Tread Softly’ video which looks at the transition from large psychiatric hospitals to local community services and is intended for practitioners, planners, managers and members from both voluntary and statutory mental health services.

scholarly journals COVD-03. IMPACT OF COVID-19 ON THERAPY PROVISION FOR CHILDREN WITH CNS TUMOURS

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii283-iii283
Author(s):  
Helen Hartley ◽  
Barry Pizer ◽  
Ram Kumar ◽  
Joanne Owen ◽  
Helen Paisley ◽  
...  
Keyword(s):  
Local Community ◽  
Local Therapy ◽  
Community Services ◽  
Future Research ◽  
Rehabilitation Team ◽  
Tertiary Centre ◽  
Time Period ◽  
Cns Tumours ◽  
The Impact ◽  
Therapy Team

Abstract INTRODUCTION The COVID-19 pandemic has led to widespread change in the delivery of rehabilitation. The Teenage Cancer Trust reported that 69% of young people with cancer saw their physiotherapist less than usual during the pandemic raising concerns about physiotherapy input. METHODS Retrospective analysis of all children’s therapy input managed under the Neuro Oncology Rehabilitation Team (NORT) between 1st April and 30th July 2020. Descriptive analysis of change to physiotherapy provision during this time period by Tertiary and local community services. RESULTS 49 children were managed under the NORT Therapy Team during this timeframe. 9 children were newly diagnosed with CNS tumours. There was no impact on inpatient therapy provision, 3 had delayed local therapy provision on discharge requiring increased virtual input by the Tertiary centre. 40 children were outpatients managed under the NORT therapy team. 16 children were also receiving regular local physiotherapy input prior to the COVID-19 pandemic. 13 of these children subsequently had their local physiotherapy input suspended during this time period, 8 children were offered virtual input as an alternative by the Tertiary centre, 2 children received increased face to face appointments at the Tertiary centre. 14 of the 24 children managed solely under the Tertiary NORT Therapy Team changed to virtual therapy reviews. DISCUSSION There is a clear change in therapy provision as a result of the COVID-19 pandemic. Future research should consider the effectiveness of neurorehabilitation conducted virtually and the impact on physical function of reduced local therapy provision in children with CNS tumours.

Diabetes Discharge Planning and Transitions of Care: A Focused Review

2019 ◽  
Vol 15 (2) ◽  
pp. 111-117 ◽  
Author(s):  
Robin L. Black ◽  
Courtney Duval
Keyword(s):  
Patient Outcomes ◽  
Hospital Admissions ◽  
Discharge Planning ◽  
Medication Management ◽  
Hospital Readmissions ◽  
The United States ◽  
Transitions Of Care ◽  
Discharge Process ◽  
The Impact ◽  
Diabetes Patients

Background: Diabetes is a growing problem in the United States. Increasing hospital admissions for diabetes patients demonstrate the need for evidence-based care of diabetes patients by inpatient providers, as well as the importance of continuity of care when transitioning patients from inpatient to outpatient providers. Methods: A focused literature review of discharge planning and transitions of care in diabetes, conducted in PubMed is presented. Studies were selected for inclusion based on content focusing on transitions of care in diabetes, risk factors for readmission, the impact of inpatient diabetes education on patient outcomes, and optimal medication management of diabetes during care transitions. American Diabetes Association (ADA) guidelines for care of patients during the discharge process are presented, as well as considerations for designing treatment regimens for a hospitalized patient transitioning to various care settings. Results: Multiple factors may make transitions of care difficult, including poor communication, poor patient education, inappropriate follow-up, and clinically complex patients. ADA recommendations provide guidance, but an individualized approach for medication management is needed. Use of scoring systems may help identify patients at higher risk for readmission. Good communication with patients and outpatient providers is needed to prevent patient harm. A team-based approach is needed, utilizing the skills of inpatient and outpatient providers, diabetes educators, nurses, and pharmacists. Conclusion: Structured discharge planning per guideline recommendations can help improve transitions in care for patients with diabetes. A team based, patient-centered approach can help improve patient outcomes by reducing medication errors, delay of care, and hospital readmissions.

81 Integrating A Front Door Frailty Service in the Emergency Department: Results of A Pilot Study

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
L Dunnell ◽  
A Shrestha ◽  
E Li ◽  
Z Khan ◽  
N Hashemi
Keyword(s):  
Emergency Department ◽  
Hospital Admissions ◽  
Admission Rate ◽  
Community Services ◽  
Service Improvement ◽  
Specialist Nurse ◽  
Front Door ◽  
Medication Changes ◽  
Health Service Improvement

Abstract Introduction Increasing old age and frailty is putting pressure on health services with 5–10% of patients attending the emergency department (ED) and 30% of patients in acute medical units classified as older and frail. National Health Service improvement mandates that by 2020 hospital trusts with type one EDs provide at least 70 hours of acute frailty service each week. Methodology A two-week pilot (Monday–Friday 8 am-5 pm) was undertaken, with a “Front Door Frailty Team” comprising a consultant, junior doctor, specialist nurse and pharmacist, with therapy input from the existing ED team. They were based in the ED seeing patients on arrival, referrals from the ED team and patients in the ED observation ward—opposed to the usual pathway of referral from the ED team to medical team. Data was captured using “Cerner” electronic healthcare records. A plan, do, study, act methodology was used throughout with daily debrief and huddle sessions. Results 95 patients were seen over two weeks. In the over 65 s, average time to be seen was 50 minutes quicker than the ED team over the same period, with reduced admission rate (25.7% vs 46.5%). The wait between decision to admit and departure was shortened by 119 minutes. Overall, this led to patients spending on average 133 minutes less in the ED. 64 patients were discharged, of which 44 had community follow-up (including 37.5% of 64 referred to acute elderly clinic and 25% to rapid response). 47 medications were stopped across 25 patients. Conclusion The pilot shows that introduction of an early comprehensive geriatric assessment in the ED can lead to patients being seen sooner, with more timely decisions over their care and reduction in hospital admissions. It allowed for greater provision of acute clinics and community services as well as prompt medication review and real time medication changes.

scholarly journals Understanding Suicide in Our Community through the Lens of the Pediatric ICU: An Epidemiological Review (2011–2017) of One Midwestern City in the US

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 59
Author(s):  
Andrew Kampfschulte ◽  
Matthew Oram ◽  
Alejandra M. Escobar Vasco ◽  
Brittany Essenmacher ◽  
Amy Herbig ◽  
...  
Keyword(s):  
Local Community ◽  
Hospital Admissions ◽  
Age Groups ◽  
Care Facility ◽  
Pediatric Intensive Care ◽  
High Volume ◽  
Temporal Variables ◽  
Geographical Regions ◽  
Icd 10 ◽  
Pediatric Icu

Suicide frequency has tripled for some pediatric age groups over the last decade, of which, serious attempts result in pediatric intensive care unit (PICU) admissions. We paired clinical, aggregate geospatial, and temporal demographics to understand local community variables to determine if epidemiological patterns emerge that associate with risk for PICU admission. Data were extracted at an urban, high-volume, quaternary care facility from January 2011 to December 2017 via ICD 10 codes associated with suicide. Clinical, socioeconomic, geographical, and temporal variables were reviewed. In total, 1036 patients over the age of 9 were included, of which n = 161 were PICU admissions. Females represented higher proportions of all suicide-related hospital admissions (67.9%). Looking at race/ethnicity, PICU admissions were largely Caucasian (83.2%); Blacks and Hispanics had lower odds of PICU admissions (OR: 0.49; 0.17, respectively). PICU-admitted patients were older (16.0 vs. 15.5; p = 0.0001), with lower basal metabolic index (23.0 vs. 22.0; p = 0.0013), and presented in summer months (OR: 1.51, p = 0.044). Time-series decomposition showed seasonal peaks in June and August. Local regions outside the city limits identified higher numbers of PICU admissions. PICUs serve discrete geographical regions and are a source of information, when paired with clinical geospatial/seasonal analyses, highlighting clinical and societal risk factors associated with PICU admissions.

Risks of financial abuse of older people with dementia: findings from a survey of UK voluntary sector dementia community services staff

2014 ◽  
Vol 16 (3) ◽  
pp. 180-192 ◽  
Author(s):  
Kritika Samsi ◽  
Jill Manthorpe ◽  
Karishma Chandaria
Keyword(s):  
Online Survey ◽  
Local Community ◽  
Community Support ◽  
Voluntary Sector ◽  
Community Services ◽  
Warning Signs ◽  
Money Management ◽  
Content Type ◽  
Financial Abuse ◽  
People With Dementia

Purpose – Financial abuse of people with dementia is of rising concern to family carers, the voluntary sector and professionals. Little is known about preventative and early response practice among community services staff. The purpose of this paper is to investigate voluntary sector staff's views of the risks of managing money when a person has a dementia and explore ways that individuals may be protected from the risks of financial abuse. Design/methodology/approach – An online survey of staff of local Alzheimer's Society groups across England was conducted in 2011 and was completed by 86 respondents. Open-ended responses supplemented survey questions. Statistical analysis and content analysis identified emergent findings. Findings – Most respondents said their people with dementia experienced problems with money management, with almost half the respondents reporting encountering cases of financial abuse over the past year. Most were alert to warning signs and vulnerabilities and offered suggestions relevant to practice and policy about prevention and risk minimization. Research limitations/implications – Adult safeguarding practitioners are likely to encounter money management uncertainties and concerns about exploitation of people with dementia. They may be contacted by community-based support staff from the voluntary sector about individual queries but could ensure that such practitioners are engaged in local training and networking activities to promote their skills and confidence. Practical implications – As with other forms of elder abuse, professionals need to be aware of risks of financial abuse and be able to suggest effective yet acceptable preventive measures and ways to reduce risks of harm and loss. Further publicity about adult safeguarding services may be needed among local community support services. Originality/value – There have been few studies investigating the views of people working with people with dementia in the community about adult safeguarding.

The complexity of social work at hospitals during the pandemic in Germany

2021 ◽  
Vol 36 (5) ◽  
pp. 5-19
Author(s):  
Anna Bocheńska-Brandt
Keyword(s):  
Social Work ◽  
Social Services ◽  
Social Life ◽  
Hospital Staff ◽  
Community Services ◽  
Steady Increase ◽  
Holistic View ◽  
Hygiene Measures ◽  
Health And Social Care ◽  
Protection Legislation

Social work is also an indispensable pillar in the healthcare of patients in hospitals (Homfeldt, 2012, p. 489). Hospital social services support patients in processing stressful diagnoses and coping with the consequences of diseases (Gödecker-Geenen, 2005, p. 19). Due to the current development of problem situations and the current structure of health and social care, social work is gaining more and more importance (Schaub, 2008, p. 17; Hofmann, 2004, p. 413). Demographic changes result in an increase in the number of elderly people and a steady increase in their life expectancy. The lack of family or financial resources creates gaps in the supply of hospital social services (Meyer, 2019, p. 9). However, the change in the spectrum of health risks and diseases from predominantly acute to chronic ones, justifies the importance of social work in these facilities (Schaub, 2008, p. 17; Lützenkirchen, 2005, pp. 10–14). The Covid-19 pandemic presents a particular challenge that has spread around the world since late 2019. It affects all areas of life and life situations (Schmitt, 2020, p. 177). Protective measures to contain the virus, such as mass gathering prohibitions, contact restrictions, minimum distance regulations, hygiene measures and masks, determine daily and social life. Preventing visits from relatives, pastors and social workers puts a new light on the holistic view of health and the disease and its social determinants (Kröll et al., 2020, pp. 7–38). Infection protection legislation also restricts community services from interacting with patients and hospital staff. Work processes and communication must change, and existing systems must be redesigned (Truell, 2020).

scholarly journals Social Work and the Development of Community-Based Social Services

2015 ◽  
Vol 1 ◽  
pp. 7-9
Author(s):  
Vilija Blinkevičiūtė
Keyword(s):  
Social Work ◽  
Social Security ◽  
Social Services ◽  
Community Services ◽  
Assistance System ◽  
Community Based ◽  
International Conference ◽  
The Social ◽  
The Republic ◽  
Present Text

The present text is the opening and welcome speech to the 4 international conference “Social work and the development of community services”, which was in 2001, Vilnius, November 23-24. The speaker was Vilija Blinkevčiūtė - the minister of Social security and work ministry of Lithuania Republic. The minister welcomed the participants of conference and presented the goals of the Eleventh Government of the Republic of Lithuania to develop and enhance the social assistance system.

scholarly journals Becoming a Carer for an Elderly Person after Discharge from an Acute Hospital Admission :

2004 ◽  
Author(s):  
Karen Grimmer ◽  
John Moss ◽  
Julie Falco
Keyword(s):  
Independent Living ◽  
Discharge Planning ◽  
Elderly Person ◽  
Community Setting ◽  
Community Services ◽  
Post Discharge ◽  
Acute Hospitals ◽  
Planning Processes ◽  
Discharge From Hospital ◽  
Patient Relationships

Objective: To describe the perceptions of people taking on a new or expanded caring role for an elderly patient recently hospitalised with a new or intensified health problem. Design: Observational study collecting qualitative data monthly for six months following patients’ discharge from hospital and attempted return to independent living in the community. Setting: Four South Australian acute hospitals (one metropolitan, three country). Subjects: 34 unpaid carers were nominated by 100 patients. 24 carers participated (17 elderly spouses, 3 younger family members, 4 neighbours and/ or friends). Results: The study highlighted carers’ perceptions of being unprepared for their new tasks, and their frustrations at the long-term and frequently significant changes to their lives brought about by assuming a caring role. Many carers felt their role had been imposed upon them without real choice, and that their own physical and emotional fitness for their new role had not been considered during discharge planning. Carers claimed to have been provided with little information about how to care for the patient, particularly when community services were seldom provided in the first week after discharge. Stresses developed in many of the carer-patient relationships, and patient and carer morale was often low for months post-discharge. Discussion: Carers indicated that their tasks could have been made easier by more timely, targeted education about their patient’s condition and their role in managing it. They would have liked greater inclusion in discharge planning processes whilst the patient was in hospital, and more timely and appropriate provision of post-discharge services that were patient- and carer-focused, and which addressed their ability to live independently in the community. Conclusion: Discharge planning systems should take greater account of the motivation and needs of carers, especially when this role is new or becoming expanded, and of the barriers they face in undertaking their role.

scholarly journals Creating Additional Census Income Topics from Linked Administrative Data

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
James Mowle
Keyword(s):  
Income Distribution ◽  
Social Services ◽  
Administrative Data ◽  
Census Data ◽  
Community Services ◽  
Wide Range ◽  
Australian Community ◽  
Linked Administrative Data ◽  
Australian Bureau Of Statistics ◽  
Integration Project

IntroductionThe Census is the largest statistical collection undertaken by the Australian Bureau of Statistics (ABS), with its data critical to informing the planning and delivery of Government and community services. While the Census measure of income supports a wide range of analysis, demand exists for additional income topics to complement and extend the range of socio economic analysis that can be undertaken. The ABS has recently developed three experimental income topics for the 2016 Census using linked administrative data: main source of income; main source of government payments; and previous financial year income. Objectives and ApproachThis research utilised administrative data integrated by the ABS for the Multi-Agency Data Integration Project (MADIP). Taxation data from the Australian Taxation Office (ATO) and social security data from the Department of Social Services (DSS) were used in conjunction with the 2016 Census data to derive the additional topics. ResultsOverall, the three measures compare relatively closely to similar measures from the ABS Survey of Income and Housing (SIH). The ‘Main source of income’ and ‘Main source of government payments’ measures exhibit similar distributions to those from the SIH. The ‘Previous financial year income’ measures compare more closely with Census and SIH at the higher end of the income distribution, with some differences apparent at the lower end of the income distribution. Conclusion / ImplicationsThis work demonstrates the potential to supplement and enhance existing Census topics with linked administrative data. Further research, development and consultation with data users and the Australian community is needed.

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