Presentation Title TRUSTED ASSESSOR 36pt Arial Bold Sub heading 24pt Arial PILOT Crystal Selley-West Senior Occupational Therapist East Surrey Hospital Carol Rickaby Community Liaison Matron First Community Health and Care An Associated University Hospital of Brighton and Sussex Medical School
Background #NOF Unit catering to patients in Surrey and Sussex primarily. A large amount of time spent on referrals and paperwork for transfer to inpatient rehab beds. Previously Community team visited wards to assess patients once referral received. Altogether time from referral to transfer could be several days or longer. Often the discharge plan could change while waiting for patient to become medically fit or for a community bed to be available.
Trusted Assessor Concept To identify Trusted Assessors on the ward to complete a comprehensive referral form and reduce the need for the community team to assess patients themselves and therefore speed up the referral process. Trusted Assessors are permanent members of the ward team - OT, PT and Nursing staff. - Band 6 or above - Have visited the various community beds and understand criteria for admission Improving the patients experience by sharing information across the teams, therefore reducing duplication of assessments.
The Process Joint meetings to agree information required by community, develop forms and identify Trusted Assessors. Staff from East Surrey Hospital visited the First Community rehab units to promote understanding of criteria and environments. OT and PT adapted their initial assessment form to be used as part of the referral form, and developed a page for current ability and goals to complete therapy section of referral. Community Matron and East Surrey Nursing Staff adapted transfer of care form to become Nursing Section of the referral form. Criteria agreed and documented. 6 page referral form agreed. Slide 4
Referral Criteria Must have East Surrey GP and be over age 18 Must be medically fit for discharge from acute hospital Must be able and willing to participate in programme of rehab Not severely cognitively impaired and able to give informed consent When patients have more complex nursing or medical needs, or moderate cognitive impairment the community team visit to assess and discuss the best location for rehab.
The Pilot Trusted Assessor Pilot commenced in Sept 2015 on #NOF Unit. Trusted Assessors were identified on the adjourning Trauma Orthopaedic Ward in November 2015 and the Pilot was extended to include referrals to ICT in Surrey. 25 patients have been referred to date 2 were not transferred as their discharge plans changed 19 patients transferred to inpatient rehab beds 3 were discharged home with ICT 1 declined input following the referral and was discharged with alternative support. Slide 6
Benefits Nursing staff no longer need to complete a transfer of care form as all the required information is included in the referral. OT and PT do not duplicate information for a therapy report as initial assessment is incorporated. Although there are 6 pages to be sent at time of referral, overall the process reduces paperwork and streamlines the referral system. The feedback has been very positive about the quality of information being sent. OT and PT use the therapy section for all therapy reports from the unit.
Future Aims To promote up-take of Trusted Assessor referrals on the Trauma Orthopaedic Ward. To extend referrals to elective orthopaedic wards To train more Trusted Assessors. To work with our Sussex colleagues to introduce Trusted Assessor referrals to the Sussex rehab beds and ICT. To combine therapy social assessment with Ortho-geriatricians #NOF Proforma to reduce repetition Slide 8