Delayed Transfer of Care Pan London Review

This report has been prepared by the NHS England Delayed Transfer of Care Programme and provides an overview of the causes of delayed transfers of care across London, and the characteristics of a good model for reducing these.

NHS England: Delayed Transfer of Care Pan London Review
A Bjorkstrand, Lead for Delayed Transfer of Care Project
March 2016

Read more here.

Quick guides: transforming urgent and emergency care services in England

"NHS England and partners have published a series of quick guides to support local health and care systems. The guides provide practical tips, case studies and links to useful documents, which can be used to implement solutions to commonly experienced issues. Use the information to manage upcoming winter pressures and plan for 2016 and beyond."

• Better use of care at home 
• Clinical input to care homes 
• Identifying local care home placements
• Improving hospital discharge into the care sector 
• Technology in care homes
• Sharing patient information 

Quick guide: Transforming urgent and emergency care services in England
NHS England
2015

All six guides can be accessed here.

Three things the NHS must do to manage clinical risk

"Every hospital admission or discharge should have an explicit understanding and agreement of risk. Unless we support clinicians to take only appropriate, managed risk, we will not succeed in truly integrating care"

Three things the NHS must do to manage clinical risk
J Inglesfield
Health Service Journal
October 2015

Read more here.

Improving the efficacy of elderly patients' hospital discharge

"After several months of sustained effort, the average time to complete eDANs fell by over an hour resulting in discharge medication dispensed earlier in the day and improved patient safety."

Improving the efficacy of elderly patients' hospital discharge through multi-professional safety briefings and behavioural change
J Corrado, K Topley, A Cracknell
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u209431.w3871

Read more here.

Improving discharge communication between secondary and primary care

"Discharge communication is an essential component of transition from secondary to primary care. Our study identifies sub-optimal discharge communication at the OUH Trust, which is likely to be reflected in other trusts. In particular, the areas of concern include medication reconciliation and follow-up plans."
Mind the gap: Improving discharge communication between secondary and primary care
A Cresswell, M Hart, O Suchanek, T Young, L Leaver, S Hibbs
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u207936.w3197

Read more here.

Improving critical care discharge summaries

"An innovative form of enhanced capability critical care outreach called ‘iMobile’ is being provided at King’s College Hospital (KCH). Part of the remit of iMobile is to review patients who have been transferred from critical care to general wards. The iMobile team wished to improve the quality of critical care discharge summaries."

Improving critical care discharge summaries: a collaborative quality improvement project using PDSA
L Goulding et al.
BMJ Quality Improvement Reports 2015;4: doi:10.1136/bmjquality.u203938.w3268

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Improving the accuracy and turn-around time of controlled drug prescribing for patients being discharged home for end-of-life care

"Re-audit after a pilot period showed a significant improvement in both error rate and dispensing time of these medications. This then allowed for better use of staff time within the pharmacy department, and a smoother and safer discharge for our patients going home for end of life care."

Improving the accuracy and turn-around time of controlled drug prescribing for patients being discharged home for end-of-life care

S Daniel, J Patel, D Benson
BMJ Quality Improvement Reports 2014;3: doi:10.1136/bmjquality.u203589.w1595

Read more here.

Improving patient discharge and reducing hospital readmissions by using Intervention Mapping

"There is a growing impetus to reorganize the hospital discharge process to reduce avoidable readmissions and costs. The aim of this study was to provide insight into hospital discharge problems and underlying causes, and to give an overview of solutions that guide providers and policy-makers in improving hospital discharge."

Improving patient discharge and reducing hospital readmissions by using Intervention Mapping
G Hesselink et al.
BMC Health Services Research 2014, 14:389

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Hospital discharge of the elderly - functions, variability and performance-shaping factors

"Precision issues related to (1) decision-making criteria concerning the medical fitness decision and appropriate level of care, (2) quality of discharge planning, (3) degree of patient involvement, and (4) quality of information transfer."

Hospital discharge of the elderly-an observational case study of functions, variability and performance-shaping factors
K Laugaland, K Aase, J Waring
BMC Health Services Research 2014, 14:365

Read more here.

Quality care outcomes following transitional care interventions for older people from hospital to home

"Gaps in the evidence base were apparent in the quality domains of timeliness, equity, efficiencies for community providers, effectiveness/symptom management, and domains of person and family centred care. Further research that involves the person and their family/caregiver in transitional care interventions is needed."

Quality care outcomes following transitional care interventions for older people from hospital to home: a systematic review
J Allen, AM Hutchinson, R Brown, PM Livingston
BMC Health Services Research 2014, 14:346

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Safely and effectively reducing inpatient length of stay

"While various interventions have been proposed to improve the efficiency and quality of inpatient care, with inconsistent results when rigorously evaluated, the General Internal Medicine Care Transformation Initiative did decrease length of stay for hospitalised GIM patients above and beyond existing secular trends in teaching hospitals without increasing post-discharge adverse events."

Safely and effectively reducing inpatient length of stay: a controlled study of the General Internal Medicine Care Transformation Initiative
FA McAlister, JA Bakal, SR Majumdar, S Dean, RS Padwal, N Kassam, M Bacchus, A Colbourne
BMJ Quality and Safety, 2014; 23: 446-456

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Telemonitoring after discharge from hospital with heart failure

"Cost-effectiveness analyses suggest that telemonitoring was an optimal strategy in most scenarios, but there is considerable uncertainty in relation to clear descriptions of the interventions and robust estimation of costs."

Telemonitoring after discharge from hospital with heart failure: cost-effectiveness modelling of alternative service designs
P Thokala, et al.
BMJ Open, 2013, 3:e003250

Read more here.

Hospital to home resource pack

This Hospital to Home Resource Pack contains essential information for all the professional sectors that have a role in hospital discharge for older people in England. It contains information, suggestions for action, case studies and checklists for considering older patients’ housing situations in hospital discharge and transfer of care and for improving integration of housing and support into the process for discharging older people.

Read more here.