The Better Health in Residents in Care Homes (BHiRCH) Project Alan Blighe BHiRCH Research Programme Manager University of Bradford 02/12/2018 Alan Blighe, Overview of the BHiRCH Project

Overview of the Project The problem we are addressing What we want to achieve How we developed the intervention The components of the intervention The BHiRCH care pathway Practice Development Champions Project participants Project timetable 02/12/2018 Alan Blighe, Overview of the BHiRCH Project

The problem we are addressing Residents in care homes Frail, vulnerable, with complex health care needs Sometimes hospitalised for conditions that could have been treated in the care home Hospitalisation is costly to the NHS and can be distressing to the resident, family and staff 02/12/2018 Alan Blighe, Overview of the BHiRCH Project

Alan Blighe, Overview of the BHiRCH Project What we want to achieve Improve health care for all residents Ensure early detection of changes in health Reduce rates of avoidable hospital admissions for: acute exacerbation of congestive heart failure respiratory tract infections urinary tract infections dehydration 02/12/2018 Alan Blighe, Overview of the BHiRCH Project

How we developed the intervention Collaborative model of development Informed by literature Consultation with: care home staff, primary care staff, family members of care home residents, academics 02/12/2018 Alan Blighe, Overview of the BHiRCH Project

Components of the intervention BHiRCH care pathway Practice Development Champions 02/12/2018 Alan Blighe, Overview of the BHiRCH Project

The BHiRCH care pathway Early warning tool Primary assessment Secondary assessment Communicate with primary care Care Care assistant & nurses Nurse Nurse Nurse 02/12/2018 Alan Blighe, Overview of the BHiRCH Project

Alan Blighe, Overview of the BHiRCH Project Early warning tool Used for noticing subtle changes in health Used by care assistants or nurses Prompted by any observation or suspicion that a resident’s health has changed Recorded in resident’s care records 02/12/2018 Alan Blighe, Overview of the BHiRCH Project

Role for family members Family members vary in their involvement in their relative’s health care. Involvement could be: Noticing changes in health Communicating these changes to staff Providing information about their relative Making decisions 02/12/2018 Alan Blighe, Overview of the BHiRCH Project

Primary & secondary assessment Conducted by nurses After being alerted by Stop & Watch tool Or every 6 hours for more intensive monitoring Nurses make a decision about care or referral Assessments recorded in care records Outcomes fed back to relevant care staff, domestic staff and family 02/12/2018 Alan Blighe, Overview of the BHiRCH Project

Communicate with primary care SBAR (Situation, Background, Assessment, Recommendation) Used by the nurse to communicate with primary care and out of hours staff Organise information on paper according to 4 elements before making contact 02/12/2018 Alan Blighe, Overview of the BHiRCH Project

Practice Development Champions Support for the role: Regular contact with Brendan and Katherine Practice Development Support Group Support materials – in hard copy and online 02/12/2018 Alan Blighe, Overview of the BHiRCH Project

Alan Blighe, Overview of the BHiRCH Project Study participants 14 care homes More than: 127 residents 140 staff 64 family members 02/12/2018 Alan Blighe, Overview of the BHiRCH Project

Alan Blighe, Overview of the BHiRCH Project Study timetable Jan 18 Intervention begins Feb to Jun 18 Monthly care home data collection Jul 18 Data collection from individuals Aug 18 to Jan 19 Jan 19 Intervention ends Feb 19 Final individual data collection 02/12/2018 Alan Blighe, Overview of the BHiRCH Project

Alan Blighe, Overview of the BHiRCH Project Thanks for listening Any questions? 02/12/2018 Alan Blighe, Overview of the BHiRCH Project