Background
Dartford and Gravesham NHS Trust wanted to improve length of stay and ensure it provided the most appropriate and effective care for the patients being treated in the medical directorate.
Identifying the problem
Using Signpost, our online corporate reporting and clinical management system, we identified where that patients had an underlying diagnosis of dementia, their length of stay increased substantially. More detailed analysis showed that it was not the patients who were discharged to a care home, but those whose dementia did not warrant a specific residential care package. A core element of the DH’s Dementia Strategy is that dementia patients are best placed in their own environment, be it in their own home or in other appropriate care settings.
Key findings
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Physicians were reluctant to discharge patients as they were uncertain of continuing care provision
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The high number of patients admitted was due to the pressure on A&E, CDU targets and high demand, whilst the acute needs of the patients were effectively managed, the physicians’ skills in managing dementia were limited.
Tackling the problem
We facilitated a multi-agency workshop to identify the failure points in the patient pathway. The workshop looked at the interrelationships between carer and providers; and the need for better awareness, communication, training and skills.
We then defined a series of metrics to evaluate, monitor and improve the care pathway. Involving the whole health economy, care agencies, patients and carers is crucial for implementing the Dementia Strategy effectively. By identifying the key failure points, the Trust can significantly reduce length of stay, improving quality of care, outcomes and patient experience, as well as driving productivity and efficiency savings.
Like Dartford and Gravesham NHS Trust, by using combined CHKS products and services, healthcare organisations are working more innovatively to improve the quality of care,
enhance the patient experience and increase efficiencies.
