Abstract
BackgroundOlder care home residents frequently attend emergency departments with a high conversion to admissions. For this purpose, a novel Care Home Innovation Programme (CHIP) was introduced with the aim of reducing potentially avoidable hospital admissions by 30%. The aim of this study is to evaluate the implementation of this innovative service in practice.MethodsA total of 32 care homes with 1314 beds in South Sefton, Merseyside were invited to sign up to CHIP which was launched in April 2015 and continued in its entirety until June 2018. As part of the CHIP, care home matrons were introduced, new protocols were developed to address common presentations, a 24-h 7–day a week televideo system installed across all homes, and a quarterly training collaborative brought care homes together to learn and share good practices together. Data on emergency calls and calls resulting in conveyances were recorded over a four-year period, and analysed using frequency analysis.ResultsIn comparison to the 12 months prior to launch, over a four-year period, implementation of the CHIP resulted in a 15% reduction of emergency calls, and in a 19% reduction of conveyances to hospital.ConclusionsThe South Sefton CHIP demonstrated itself an effective programme in reducing conveyances and consequently, hospital admissions of care home residents. This model will be superseded by the enhanced health in care homes being promoted by the NHS Long Term Care Plan.
Highlights
Older care home residents frequently attend emergency departments with a high conversion to admissions
Time-series analysis showed that the number of 999 calls made was reduced by 15.1% over the three-year period compared to the 12 months prior to Care Home Innovation Programme (CHIP) (p = 0.002, Mann-Whitney)
The CHIP service effectively reduced hospital admissions by 19%, by employing a multi-disciplinary team (MDT), a televideo system, and replacing all previous incident protocols with new ones and training up care home staff to employ the new system
Summary
Older care home residents frequently attend emergency departments with a high conversion to admissions. For this purpose, a novel Care Home Innovation Programme (CHIP) was introduced with the aim of reducing potentially avoidable hospital admissions by 30%. When caring for someone in their own home becomes too stressful and demanding as a consequence of physical or mental ill health, people often move into a care home. In England and Wales, over 291,000 people aged 65 and above were residing in a care home in the last national count [11], representing 3.2% of older adults overall. Hospitalisation and attending emergency departments should be avoided as much as possible, and care home residents should be supported and cared for safely in their residence
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