1. Whos in the beds? Experience of using the AEP in the UK Paul Forte ORAHS Working Group Prague, July 2003

2. 2 Coming up shortly… Brief overview of the AEP (Appropriateness Evaluation Protocol) Illustrative results from a recent project using the AEP Issues concerning the application and extension of the AEP

3. 3 What is the AEP ? A validated protocol used to determine: –the appropriateness of acute admission –the continued occupation of acute beds Enables exploration of the potential for alternative care and treatment pathways Based on data from patient notes

4. 4 Why use the AEP ? Efficiency –Contributes to a whole systems analysis –Identifies potential service improvements Quality –Appropriate care and locations for patients –Re-orientates focus of services Modelling –Provides quantification (whos in the beds) and support for capacity planning

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6. 6 295 out of 661 acute patients (45%) were not receiving care within AEP criteria on the day of the survey

7. 7 Hospital types and rehabilitation Acute, non-acute, and community hospital wards Types of rehabilitation: –recuperative (convalescence) –restorative (eg. post fractured neck of femur) –reconstructive (eg. post stroke)

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10. 10 Illustrative capacity calculation

11. 11 The AEP experience Establishing survey objectives Survey mechanics Reporting findings and local buy-in Using the results Engaging key players

12. 12 AEP – what next? Broadening the AEP scope –Development of rehabilitation and sub-acute care criteria –Updating for clinical practice changes Embedding results –A fundamental issue in OR –Patient and referring clinician views

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14. 14 What the AEP effort contributes to modelling the whole system?