Acute Care: Improving patient’s motivation and capability to self-care
Recently, Flo has been taking greats strides forwards in secondary care with a significant increase in acute sector leaders recognising the value in supporting their patients to improve their capability and confidence to self-care, thereby delivering not only improved clinical outcomes but also increased productivity and capacity within teams.
With ever increasing demand and a clear requirement to deliver higher quality at less cost, enabling patients to become active participants in their health care, confident in their condition management and how to access the right service, at the right time is key for the acute sector. Offering teams the opportunity to take a fresh look at their pathways with a tangible alternative has resulted in harnessing clinical enthusiasm and a number of new innovations.
Recent Highlights
Nottinghamshire – East Midlands AHSN
The East Midlands Academic Health Science Network have further supported the Nottinghamshire Assistive Technology Team in focusing on clinical adoption of Flo specifically within acute care pathways. Recognising the momentum generated in the 1st 12 months of a funded role the opportunity exists for further consolidation of current pathways and extending adoption further, for more information please contact carol.turner@mansfieldandashfieldccg.nhs.uk. Some examples of the pathways developed are below:
Follow up – Hop and Knee Surgery
Supporting triage of patients to facilitate discharge from follow-up 12 months post op. Outcomes include improving the appropriate allocation of follow up appointments only where clinically indicated thus safely releasing clinic capacity to see new (impacting on 18 week RTT) or triaged follow up patients, improving new : follow up ratio, improving peaks and troughs in radiology and improving patient experience.
Hepatology
Weight monitoring of patients at risk of Ascites for early intervention to identify exacerbation of condition resulting improvement patient compliance to medication and reduced admissions.
Novel methods of managing alcoholic liver disease
Pre – Operative Hypertension
Pre-operative blood pressure monitoring initiated at surgical pre-assessment indicated by a raised blood pressure reading that may previously have delayed surgery. Results include a reduction in clinic appointments, GP referrals, cancelled surgical operations and improved patient satisfaction. Based on the initial implementation at Sherwood Forest Hospital this pathway is being spread across other Nottinghamshire Trusts.
Management of pre-op hypertension
Parkinson’s Disease
Supporting specific medication adherence to avoid associated side effects of non-compliance leading to capacity generation within teams for more urgent patients and supporting admission avoidance.
Early Supported Discharge (Stroke)
Improving patient compliance, leading to speedier discharge and increased bed capacity and team productivity.
City Hospitals Sunderland – North East and Cumbria AHSN
The best practice harnessed from Flo’s integration across two common pregnancy pathways at City Hospitals Sunderland, evaluated with the support of the North East and Cumbria Academic Health Science Network and generating CQC praise as “outstanding practice” is now being spread to Friarage Hospitals, The James Cook University Hospital, South Tyneside District Hospital and Newcastle upon Tyne Hospitals to name a few.
Implementation of Flo at City Hospitals Sunderland highlighted in CQC report as outstanding practice
Gestational Diabetes
Improve and increase real time glucose monitoring to facilitate earlier intervention, release clinic capacity and improve patient experience.
Pregnancy Induced Hypertension
Improve and increase real time BP monitoring to facilitate earlier intervention, education of patients in symptom recognition, improving patient experience and reducing antenatal appointments.
Maternity – Breastfeeding
Providing extended support to new Mums upon discharge from hospital to educate and motivate towards continuation of breastfeeding demonstrating significantly improved 6-week breastfeeding compliance rates resulting in wide ranging and long lasting benefits to Mum and baby.
Newcastle upon Tyne Hospitals
Pathways are progressing with oncology, neurology, epilepsy and breast cancer teams integrating Flo to drive forward both quality, outcomes and satisfaction.
Deep Brain Stimulation
Improved safety of surgery scheduling, assurance of equipment performance to identify any technical issues earlier and increasing patient’s confidence.
Epilepsy
Aimed to improve seizure control, patients are supported to comply with their treatment regime to avoid side effects of non-compliance and avoidable attendances and/or admissions.
Breast Cancer
Creating safe opportunities for supported early discharge post-surgery with reassurance that key post-discharge indicators of additional clinical need can be identified and managed.
Other UK Acute Care examples
Early Discharge – Pulmonary Rehabilitation
Enabling patients identified for early discharge to self-care in-between face-to-face contact providing opportunity for early intervention of exacerbation if necessary. Also to confirm patients are fit to undertake their prescribed physiotherapy exercises post discharge, or not as appropriate providing richer information for effective clinical decision-making.
Heart Failure
Monitoring of vital measurement to indicate when intervention is required from the team for admission avoidance and motivate patients to self care or access specialist input as required.
Nephrology
Pre outpatient appointment BP reading collection to reduce DNAs, improve value of appointment, increase clinic flow, improved clinical decision making.
Weight Management
Pre-bariatric surgery remote intervention combined with12-week post surgery weight monitoring improving patient compliance to pre-op weight loss goals and improved outcomes generated via improved awareness and compliance post surgically.
Paediatric Asthma
Symptom monitoring and improved correct inhaler compliance, increasing patient awareness of symptoms facilitating early intervention and prevention of exacerbation and admission.
COPD
Medication prompts, Nebuliser reminder increasing medication compliance, symptom-monitoring facilitating early intervention.
Parkinsons
Support in improving patient medication compliance aimed to identify postural drop and reduce side effects from non-compliance to reduce avoidable admissions and increase capacity.
Pre-Operative Vitamin K
Compliance to vitamin K medication pre-operatively, reducing cancelled operations and supporting better outcomes.
Oncology
Supporting patients to manage their post chemotherapy symptoms to allow intervention before condition exacerbates and requires admission.
Sleep Service
Supporting patients to comply with their prescribed treatment regime and use their CPAP safely, facilitating equipment remaining in good working order and highlighting where issues have arisen to enable the patient having high levels of access to their prescribed treatment.
