11 A QUALITY IMPROVEMENT INITIATIVE TO MAXIMISE UTILISATION OF EARLY SUPPORTED DISCHARGE SERVICE IN A LEVEL 3 HOSPITAL SETTING

Abstract

Abstract Background Early Supported Discharge (ESD) originated in stroke care however also applies to general medical patients. This ESD service was funded by the local Integrated Care Programme for Older Persons (ICPOP) and saw over 100 patients in its first year. A review of current ESD criteria and limitations was undertaken Methods Data was collected, by chart review, over a 2-week period on medical wards. A general townland was used as the patient's address. All patients aged over 70 were included. ESD criteria include all of: living within 30km of the hospital, not living alone, assistance of 1 with mobility or Activities of Daily Living, medically discharged. Results 91 patients aged over 70 years included 54 patients were medically discharged 27% of medically suitable patients lived outside the ESD radius 2 of 12 patients that met all ESD criteria but had been referred Conclusion From our data 54 patients met some ESD criteria but awaited assessment by the multidisciplinary team (MDT). Only 2 of 12 patients who met all criteria were referred to ESD. Education campaigns are ongoing within the hospital to increase awareness of the service. This includes a daily discharge huddle to identify potential candidates. Distance from the hospital was identified as a limiting factor. A business case is under development to support increasing this radius to allow an increased number of patients to avail of the service. ESD has been utilised successfully in urban settings. The continued success of this new service in a rural setting requires ongoing education to increase awareness of the service and development of existing criteria. Limited access to therapists in hospital reduces the effectiveness of ESD.