P199 Common themes for delays to discharge for patients with motor neurone disease when admitted to a specialist ventilation unit

Abstract

Objective To identify factors contributing to delays in discharge for patients with Motor Neurone Disease (MND) admitted to a Specialist Ventilation Unit. Background Long Term Non-Invasive Ventilation (NIV) is considered the standard of care for patients with MND who are developing type II respiratory failure. Establishing patients on NIV may lead to a delay in hospital discharge and associated healthcare costs due to increased complex care needs. Methods A retrospective service evaluation of patients with a confirmed diagnosis of MND admitted to the North West Ventilation Unit (Wythenshawe Hospital, Manchester University NHS Foundation Trust), was performed over a six month period, from June to November 2017, to identify reasons for delay in discharge from hospital. Basic demographics, length of stay and delay, reason for admission and delay and admitting location were collected for each patient. Comparison of groups was performed using Mann-Whitney Test and Fisher’s exact test in SPSS v22. Results Forty two of the 45 patients survived to hospital discharge. The mean age was 68 years and 60% were male. Median length of stay was five days with delays in discharge occurring in 13 (29%) patients. The delay in discharge was significantly longer in those patients admitted to be established on NIV compared to those admitted for other reasons (PEG insertion etc) with delays predominantly related to social care issues. Patients transferred from another hospital had a significantly extended length of stay compared to those patients admitted from home. Additionally a greater proportion of patients transferred from another hospital had a delay in discharge, with a large number awaiting repatriation to their local hospital. Conclusion Early discharge planning should be focused on patients with MND admitted to be established on NIV or following transfer from another centre.