CASE STUDY - Get Patients Out of the Hospital Sooner and Lower Costs  

Introducing – Sue Farrelly, Occupational Therapist, Heartlands Hospital, Birmingham   

Sue contacted Birmingham City Council’s Careline service to see if  there was any assistive technology available and suitable to expedite a safe discharge of one of her patients, Mr. B, from an acute medical ward back to supported independent community living. Mr. B is a 60 year old with multiple medical and mental health problems. Sue had tried the standard referral route through the Birmingham Telecare service, but  they were unable to support the patient.

Challenge  

The progressive nature of the patient’s Multiple Sclerosis (MS) was causing neurological deficits, namely an ataxic gait, reduced balance and altered sensory feedback, causing him to have falls. Furthermore, the patient’s safety was compromised due to the risk of hypoglycaemic attacks secondary to poorly controlled Insulin Dependent Diabetes Mellitus, (IDDM).

Also due to the patient’s learning disabilities, he had limited insight into the  risk factors associated with his IDDM and was not always able to recognise the early warning signs that indicate onset of a hypoglycaemic attack. As a result, he would not be able to alert for help using a standard pendant alarm, as he would become too unresponsive to activate it. This meant that he was increasingly at risk of episodes of unconsciousness, which could ultimately prove fatal.

Due to the deterioration in the patient’s physical abilities, he was unable to return to his previous accommodation as he required one level living. As part of his discharge plan, he was provided with a bungalow, which was some distance from the area where he was formerly living and meant that he would have a reduced local social support network, especially as he had no next of kin.

It was even more imperative that there were safeguards in place, which could  be remotely monitored without relying on the patient to activate them. This  was most important overnight, as his care package only covered daytime carer and support worker visits.

Solution  

A demonstration of the AIM Solution was presented and an installation agreed as part of a trial with a view to making the system permanent if proven successful.

Results  

The AIM Solution was installed in the patient’s property allowing him to  be discharged from hospital, giving him the confidence that he could live  independently and have the reassurance of knowing that the Careline service  would be contacted automatically, if he became unconscious and had a fall. Sue commented, “Had the AIM Solution been available through direct referral, this would have prevented a protracted length of stay for Mr. B. His overall admission was a total of 58 bed days, which far exceed the average for an acute hospital ward. The estimated cost of this length of stay was £23,200 based on an average cost of £400 per bed day.”  This estimated cost was not in proportion with the conditions with which Mr. B was admitted, far exceeding routine costs. This had financial implications for the Trust in terms of breaching length of stay averages and also detrimentally affecting performance related measures for the ward where he was based.