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Dr Angela Wilkinson Consultant Physician
February 2020
The H@H teams
Rolled out over 3 localities –commenced April 2012
Glenrothes & North East Kirkcaldy & Levenmouth Dunfermline & West
Dr Angela Wilkinson Consultant Physician February 2020 The H@H - - PowerPoint PPT Presentation
Dr Angela Wilkinson Consultant Physician February 2020 The H@H - - PowerPoint PPT Presentation
Dr Angela Wilkinson Consultant Physician February 2020 The H@H teams Rolled out over 3 localities commenced April 2012 Glenrothes & North East Kirkcaldy & Levenmouth Dunfermline & West ICASS (Integrated Community Assessment
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ICASS (Integrated Community Assessment & Support Service)
- A SINGLE Single Point of Access (SPOA)
- Co-located offices
- H@H
- ICT (Intermediate Care Team)
- CRT (Community Rehab Team)
- Community PT
- Day Hospital / Hubs
- High Health Gain/Complex Care Mx
- DPDS (dementia support)
- Marie Curie
- Day Hospital/Day Care
- Specialist Nurse
practitioner
- Community rehab team
- Community mental health
team
- Home Care Re-ablement
- Community Intermediate
Care teams
- District Nurse
- Home care
- Anticipatory care
- Self care
- Tele-care and health
- Respite care
- Support for Carers
- Voluntary organisations
- Social Enterprises
- Palliative Care
VIRTUAL WARD
- Geriatrician
- Specialist
Nurse consultant
- GP with
specialist interest
S P O A
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Each H@H Team
Consultant Geriatrician Band 7 team lead ( 1 West + 1 East) CdF or GPST FY2 Nurses
Band 7 Trainee ANPs x2 Band 6 NPs x6 Band 5 Nurses x3 Band 3 Healthcare Support Workers x4
Admin support AHPs Pharmacy input
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What can/can’t we do?
Can do:
CANNOT do:
IV furosemide Scut furosemide IV antibiotics (max TDS dosing) Scut fluids / IV fluid ‘bolus’ / combo (max feasible is 2l in 24hr ) Patient obs TDS max Blood tests once/day IV Pamidronate / zolendronate Use midlines (can’t insert them) Syringe drivers / end of life care Low dose oxygen (2L or use SHOOF) RCC transfusion Continuous IVI Vancomycin / QDS IV Abx regimes QDS visits Magnesium infusions IV Digoxin (needs cardiac monitor) Accurate urine output monitoring is tricky at home/NH!
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An expanding service.....
End year 2012 2013 2014 2015 2016 2017 2018 2019 TOTAL End 2015 Admissions to H@H / YEAR 232 768 1571 1839 2113 2020 1886 1790 12,219
~150 patients ‘admitted’ to H@H per month in 2019
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14 15 15 11 10 8 5 8 8 12 8 11 10 11 8 10 11 12 12 12 12 14 14 3 19 13 19 19 4 16 20 21 25 26 26 24 26 21 12 22 20 14 18 14 14 5 10 15 20 25 30 35 40 Number of Patient's on Caseload
H@H - January 2019
East Division: Patient's West Division: Patient's
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25 30 35 40 45 50 55 60 65 AVERAGE WEEKLY referrals Q1 (2017) to Q2 (2019)
AVERAGE WEEKLY referral (% per quarter) GP vs S/D
GP % SD %
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9.1 10.6 9.5 7.6 8.0 7.2 7.0 10.3 10.3 6.2 5.7 6.3 7.2 6.8 5.4 5.9 5.9 6.3 5.6 0.0 2.0 4.0 6.0 8.0 10.0 12.0 Q1 2015 Q2 2015 Q3 2015 Q4 2015 Q1 2016 Q2 2016 Q3 2016 Q4 2016 Q1 2017 Q2 2017 Q3 2017 Q4 2017 Q1 2018 Q2 2018 Q3 2018 Q4 2018 Q1 2019 Q2 2019 Q3 2019 Days Yearly Quarters
Quarterly Average Length of Stay
H@H D&WF H@H GNEF H@H K&L Fife Average
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15.0% 17.2% 16.7% 15.7% 16.1% 15.6% 14.8% 13.6% 13.6% 13.4% 10.8% 8.6% 14.1% 21.6% 16.3% 17.9% 18.7% 9.0% 12.3% 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% Q1 2015 Q2 2015 Q3 2015 Q4 2015 Q1 2016 Q2 2016 Q3 2016 Q4 2016 Q1 2017 Q2 2017 Q3 2017 Q4 2017 Q1 2018 Q2 2018 Q3 2018 Q4 2018 Q1 2019 Q2 2019 Q3 2019 Percentage Yearly Quarters
Fife H@H Rate of Re-admissions Per Quarter - Q1 2015 to Q3 2019
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Transfers to acute from H@H
0% 2% 4% 6% 8% 10% 12% 14% Q1 2019 Q2 2019 Q3 2019 Q4 2019 Quarterly transfer rate to acute hospital %
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My ACP
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