achieve change across regional health and social care sectors
BMC Health Services Research 2017v 17:387 https://doi.org/10.1186/s12913-017-2334-9
- This paper describes use of rapid cycles of PDSA tests to support the development of a community based Hospital at Home service for older people in the Exeter sub-locality to enable appropriate admission avoidance and early supported discharge.
- The new service included a single point of access for referrals, joint geriatrician and community rehabilitation practitioners review for both admission avoidance and early supported discharge, extended weekday and weekend working hours, and an acute hospital ‘step-down’ ward for patients who were no longer acutely unwell.
- While discharge destination, length of hospital stay and number of referrals to the community team remained stable this was achieved against a backdrop of intense financial pressures, significant community bed closures, and difficult relations between hospital and community services.
