Fast, safe and effective hospital discharges

Patients are benefiting from a safer and faster discharge system being piloted by Blackpool Teaching Hospitals.

Home First is a fully supported discharge method which is getting people the care they need within the community while freeing up bed spaces and reducing readmissions.

Occupational therapist and physiotherapy manager, Charlotte Stubbs, explained: “Home First is a culture that we are trying to encompass within the hospital. It allows medically stable patients to go home for assessment and get social care support.

Patient John Killeen is taken home using the Home First system. He is pictured with; Kate Garton (physio), Sarah Stewart (technical instructor), Julie Ashworth and Amanda Cooper from the Red Cross

“Home is better for the patient because you are taking them out of the hospital environment where they may be more susceptible to hospital borne infections and physical decline.”

With Home First the Red Cross take the patient home and they are met at the door of their house by a therapist who is part of the Early Supported Discharge team. The patient is then taken round each room of their house to see how they cope with such activities as cooking, personal hygiene and going up or down stairs.

Charlotte, who is also the clinical lead for the Home First initiative, added: “The therapist will also look at access to and from the property and will advise on any emergency equipment that is needed to make the home safe.

“They will discuss with the patient what social or health care is needed and what support is required to get them back to their daily routine. The patient will then be referred to the nurses and therapists in the community services for ongoing support.”

Prior to the Home First system the patient would have stayed in hospital awaiting the allocation of a care package and further assessment.

If a patient was taken home and the therapist believed they were not safe to cope, the hospital bed would be kept free for them for two hours so they could be returned to the ward.

Since the pilot started three months ago it has helped 65 patients return home early. Two had to be referred back to their hospital ward and two were transferred to Clifton Hospital for extra support.

The Home First package remains in place until a social worker follows that patient up, usually after 3 to 5 days and they will then take over the ongoing care.

To qualify for Home First, a patient must be medically stable and need ongoing support to regain an independent life. They do not necessarily have to be elderly, they could be an amputee, have MS, frailty or dementia.

Referrals are usually from ward staff, therapists, discharge facilitators or the Hospital Discharge Team. Home First is a test scheme designed to allow the hospital to learn from experience and develop the service as appropriate.

Charlotte added: “We are all very passionate that home is where patients should be if they are medically able. The challenge for us is to co-ordinate the discharge in a safe and effective way.”

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