RAPID EMERGENCY ASSESSMENT COMMUNICATION TEAM Sue Colfer OT Amy Byfield OT
Introduce REACT Reasoning for REACT Define Role Who can be referred What we can achieve
A&E Majors and Minors CDU Fracture Clinic Physiotherapy out patients Ambulatory Care AMU (W20)
MONDAY-FRIDAY 0800-16.00 During winter 08.00-20.00 Contact via Phone X40982 Contact via Bleep 0213 WEEKENDS 0800-16.00 During winter 08.00-20.00 Contact via bleep, extension number or through Switch
Band 7 Occupational Therapist (Team Lead) Band 5 Physiotherapist-CURRENT VACANCY X2 Band 6 Occupational Therapists X2 Band 4 Multi Skilled Technicians Band 3 Multi Skilled Technician
The aim of REACT is to prevent unnecessary admission to hospital for individuals who have been identified as having a physical, social or functional need but who are classed as medically fit
Any period of illness or acute injury has a major affect on an elderly persons ability to perform ADL (Rowland et al, 1990; Denham et al, 1989) One study found that out of 100 elderly patients suffering a minor trauma, 26 were more dependent in one or more functional activities and reliant on support from family and neighbours. In addition eight patients were re-admitted to hospital within 14 days of discharge (Rosenfield et al, 1990)
Hospital admissions and length of stay have been identified before as risk factors for acquisition of infection (Health Protection Agency 2002) Approximately 300,000 patients in England develop an infection whilst being treated by the NHS. (NICE 2014) HAI are the direct cause of 5,000 deaths and are the contributing cause of 15,000 deaths in the UK (NHS Scotland 2009)
Patients who are medically fit and have one or more.. Social need Require support for washing, dressing, meal preparation, assistance with transfers Not safe at home due to reduced mobility, function, confusion No family or social support Physical need Unable to mobilise, transfer or climb stairs independently Functional need Not able to perform activities of daily living independently
Facilitate safe discharge through... Comprehensive functional assessment Immediate provision of equipment essential for D/C Access to community services including ANP s Immediate access to Packages of Care Access to SID therapy team for rehab at home Immediate access to a technician who can fit emergency stair rails/grab rails as required and other minor adaptations
SPA- Birmingham & Solihull POP beds for Birmingham & Solihull patients Medical Day Hospital- Falls Clinic- Balance & Gait Classes Intermediate Care- Admission prevention beds- Rehab beds-sid, Rehab at Home, Falls Group, Parkinson s Group/clinic Rapid Access Clinic- in partnership with Geriatrician front door service Community Matrons Outside Agencies- Age Concern, Red Cross, SSAFA, Welfare associations
Jim who is in his mid 80 s Lives Alone in a house Usually independent with most Activities of Daily Living Daughter usually assists with shopping and housework however is away on holiday Attended A&E following a Fall X rays NBI Mobility & confidence now reduced
Following Medical Review and all investigations complete & results clearly documented (bloods, lying/standing BP, x rays) Jim is deemed to bemedically fit for d/c Referral received Assessment completed with Jim s consent including a full social history, transfers, mobility & stairs following REACT assessment it was identified that Jim will require 2 Zimmer Frames and 2 nd Stair Rail Referred to SPA for assistance with ADL s Follow up by SID team to improve confidence & mobility
REACT see patients who are medically fit for discharge We work with individuals who have a social, functional or physical need We only cover our allocated areas in A&E, out patients and Acute Medicine We have the ability to access rehabilitation & admission prevention beds We can deliver and fit necessary adaptive equipment required for D/C We can put Packages of Care in place the same day We regularly make onward referrals to other healthcare professionals to address on-going needs/concerns and to prevent unnecessary readmission
April 2015 297 referrals received- of which 248 were discharged 243 of these returned home 5 went to admission avoidance beds 49 of these patients were admitted as 26 were not medically fit 11 were not pain controlled 6 required a community bed which was not available at that time 4 had active safe guarding issues to be addressed 2 required SW input but SW were unable to assess that day
Encourage patients to get out of bed & mobilise as able/appropriate Ensure ALL requested investigations are complete with results clearly documented All prescribed analgesia administered Ensure walking aids issued to patients are taken home Ensure NOK contact details are documented along with all relevant info from family.
Any Questions?