Supporting residents through technology-enabled care at home

Issue being addressed

Like the rest of the country, Leicester, Leicestershire and Rutland has faced increases in ambulance call-outs and hospital admissions for residents from care homes.

Furthermore, in Leicester, 80% of emergency department admissions for sepsis come from the community, resulting in extended and preventable hospital admissions.

The local health and care system believed there was an opportunity to harness the benefits of technology, helping upskill care home staff and improve the response to patients in the community.

This led to the development of the Connected Care programme and Whzan telehealth system which enables primary care to ‘have a set of eyes inside each care home’. It equally allows staff to have a bigger voice from within, enabling a clinical conversation that initiates a timely response to their worries and concerns.

 

Action taken

The easy-to-use Whzan blue box allows residents’ vital signs to be taken and then remotely accessed by clinicians, including their GP. Clinical decisions and escalations can be made without the need for any unnecessary escalation through an inappropriate pathway. In addition, the National Early Warning Score (NEWS2) was used as an additional tool, to detect sign of early deterioration in residents.

Tech-enabled care has provided the opportunity for social care staff in all areas to access these tools and improve the sharing of information regarding residents in their care. The digital tools have also been used as part of weekly staff multi-disciplinary meetings, helping build relationships and share learning.

This co-produced programme included teams in all areas, in total, 829 care homes beds were included in the pilot programme, spanning all of Leicester, Leicestershire and Rutland.

Managing deterioration proactively can improve timely intervention from a clinician. A prolonged hospital admission often results in deconditioning, meaning the person may require ongoing support such as physiotherapy and may not be able to return to the place of their choice. The ambition was to enable staff to recognise and escalate concerns using a validated tool recognised system-wide, enabling early intervention and management from visiting teams.

 

Outcomes

These Hands Academy led the cost benefit analysis of the programme which demonstrated savings of more than £600,000 in the first four months.

Care homes were asked about the time they spent waiting for GP call-backs – in some areas this equated to three-and-a-half hours per week. Having the confidence to escalate concerns while having the data available at hand grew credibility and trust between homes and their GPs. The response time reduced to just 15 minutes, releasing valuable time to care for the residents in other meaningful activities.

Over 5,800 vital sign observations were recorded in the Whzan data, of those 422 were NEWS2 scores. There has been a demonstrable impact on reducing hospital admissions and the length of stay for those that were admitted.

A care home manager said: “We used it when a resident was very unwell and were able to get a good response from the GP and able to start antibiotics without delay, with positive outcomes for the resident and avoided a hospital admission.”

View a video of Chris, a resident of Willowbrook Residential Care Home in Rutland, who has had his vital signs measured as part of this programme: https://www.youtube.com/watch?v=gt6kd2kPiPM

This programme has demonstrated the impact of proactive care planning for the users and also the wider system enabling the programme to fund next steps benefitting more people across LLR to join the connected care programme.

Further information and resources from the Providing Care website: https://providingcare.net

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