Abstract
As a response to winter pressures, the Trust via it’s Enhanced Care at Home (ECAH) / Hospital at Home (H@H) services wishes to collaborate with care homes to support residents through timely clinical decision-making. This is about identifying the ‘softer signs’ of deterioration and providing a clinical alternative by using Tytocare for clinical consultation and examination, whilst connecting the relevant clinical decision-makers to provide alternatives to acute care, as appropriate.
We are collaborating with 30 Care Homes within the Trust to enhance the clinical decision-making for each resident linking individuals, the H@H/ECAH services, Consultants, GPs, the care home staff and families remotely.
It is envisaged that the introduction of TytoCare as a clinical examination and communication solution will help save resources through physical examinations/consultations carried out remotely for care home residents and improve user experience by reducing the need for emergency care through earlier clinical decision-making supported by the H@H and ECAH services.
The Trust reviewed its Emergency Department (ED) attendances and identified Homes by rank order of attendances over the last year. Each Home received an introductory phone-call with a follow-up email and an invitation to participate. This was followed up with a face-to-face visit and demonstration of the technology.
Phase one of the project was about getting 30 units utilised and linking the Homes to the appropriate service initially for further training support and utilizing the technology. Phase two is about traction and getting the Homes and the H@H and ECAH teams collaborating and blending the technology into clinical practice.
Monthly engagement meetings are underway to address the management of the deteriorating resident; reaching out for help earlier; staff training; experiences and ideas to promote usage of the technology and services as an alternative to ED attendance.
Working to a project plan and introducing Tyto virtual consultations, our project focuses on:-
1.Early identification of the deteriorating resident leading to
prompter action
2.Enabling virtual consultations and examinations with
clinical teams, avoiding hospital visits, reducing hospital
admissions, and travelling for clinical teams
3.Enhancing the clinical decision-making for each resident
linking residents, the H@H/ECAH services, consultants,
GPs, care home staff and families remotely.
Early outcomes:-
- The ability, confidence & trust to provide an accurate
clinical diagnosis remotely
- Reduction in travel time & transport
- Improved workforce planning & capacity
- Better access & continuity of care
- Enhancing relationships between the Trust and Care
Homes.
Technology, such as Tyto, as a clinical communication solution can bring clinical examinations and decision making outside the clinical environment into the person’s own Home supported by non-hospital based healthcare professionals.
We are working on the need to build up evidence linked to confidence in using the Tyto system. We wish to continually improve, develop and scale-up using PDSA methodology (plan, do, study and act) in our service delivery and transformation to support residents in their own Home, who do not require to be in hospital.