All Together Better Sunderland A Vanguard Multi-Speciality Community Provider Care Home Digital NEWS tablet Rachael Forbister – TECS Programme Manager Jason Lewins – Support Officer
Introduction and background
Why focus on Care Home Residents ? Complex healthcare needs, multiple long term conditions Social care model is necessary but not sufficient NHS withdrew services as independent sector grew over past 10 years Care home providers cannot deliver improvement without support No model of co-ordinated healthcare has been developed Residents don’t have equitable access to healthcare leading to hospital admissions
What we did and how we did it
The National Early Warning Score (RCP 2012) “Standardised assessment”
What is the National Early Warning Score ? A simple scoring system in which a score is allocated to physiological measurements Base line NEWS – ‘Track & trigger’ function Person focused Utility in all settings Free e-learning package - http://tfnews.ocbmedia.com
What NEWS means to care homes Aids recognition of clinical deterioration Standardises acute illness assessment in the community care setting Enables communication to other HCP’s using a common language Informs appropriate clinical response and pre-alert which defines appropriate level of on-going care required. Decision support tool – ‘defensible decisions & actions’ Objective clinical information to support requests for home visits Family and friends ‘confidence’
What does it mean for the care home staff? Empowers the staff Helps staff members look after the health of their residents more proactively Upskills staff members and invests in the team Helps keeps residents in their homes
Video clip
Clinical Response Tool
The Blue Box
Telehealth Whzan Kit Contents of kit: Blood Pressure Monitor Pulse Oximeter Thermometer Digital Tablet Battery Pack
Secure Login Screen
List of Residents Screen
Pulse Oximeter Screen
Graph View of readings
NEWS Screen
NEWS Score/Risk Rating
Case Study 1 Bill is a 70 year old resident with a 3 day history of a chest infection with a previous medical history of pneumonia. Bill has been recently prescribed Amoxicillin by his GP. He has been placed on daily NEWS to monitor his condition. Respiratory rate = 20 breaths per minute Oxygen Saturations = 94% Supplemental oxygen = No Temperature = 38.4 Systolic Blood pressure =150 Heart Rate = 105 beats per minute Level of Consciousness = Alert
Result NEWS=3
NEWS Any Questions?
Expected Outcomes Reduction in 111 and 999 calls Reduction in A&E visits and emergency admissions Improved early detection of acutely unwell residents Sharing of clinical information across all providers Promotes collaborative working with providers Improved safety and quality of information on handover
The Challenges! Culture change Training time Embedding the technology Sustaining momentum Investing the time
Contact details Rachael Forbister Rachael.forbister@nhs.net Jason Lewins Jason.lewins1@sunderland.gov.uk