The impact of the Community Care (Delayed Discharge) Act 2003 on the length of stay and bed occupancy in Old Age Psychiatry Units in England

2007 ◽  
Vol 22 (11) ◽  
pp. 1164-1165 ◽  
Author(s):  
Ajit Shah
Keyword(s):  
Length Of Stay ◽  
Old Age ◽  
Community Care ◽  
Bed Occupancy ◽  
Delayed Discharge ◽  
Old Age Psychiatry ◽  
The Impact

scholarly journals An audit: fitness to drive assessment in inpatients of general adult and old age psychiatry

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S200-S201
Author(s):  
Ismail Khan ◽  
Nneamaka Asiodu ◽  
Dr Divyanish ◽  
Anum Yaqoob ◽  
Hasanain Qureshi
Keyword(s):  
Old Age ◽  
Social Withdrawal ◽  
Data Collection Tool ◽  
Fitness To Drive ◽  
Good Medical Practice ◽  
Adult Psychiatry ◽  
Old Age Psychiatry ◽  
Duty To Inform ◽  
The Impact ◽  
Physical Health Screening

AimsTo determine if fitness to drive is assessed on admission and discharge, if applicable, and for this to be documented during clerking and on discharge notifications.To determine if patients are being educated about the impact of their condition on the ability to safely drive.To ascertain if patients are aware of the duty to inform the DVLA if they for any reason are not fit to drive.BackgroundRisk factors include social, behavior and iatrogenic factors such as social withdrawal, increased likelihood of substance abuse and side effects of anti-psychotic medication.MethodThis trust wide audit involved the random sampling of a total of 71 case notes, 4 case notes per Consultant team in general adult psychiatry and old age psychiatry across Dudley and Walsall sites (total of 3 sites). A data collection tool was developed and included relevant questions regarding fitness to drive. Data were collected between October and December 2019.Result18/49 patients had physical health screening prior to medication initiation.ConclusionAn important aspect of good medical practice is to educate patients about their condition, this includes their fitness to drive as this can be affected both by their diagnosis and medication. It is clear that clinicians also need to be educated about this responsibility to ensure assessment is performed especially on inpatient discharge.

scholarly journals Better care: reducing length of stay and bed occupancy on an older adult psychiatric ward

2018 ◽  
Vol 7 (4) ◽  
pp. e000149 ◽  
Author(s):  
Katherine Adlington ◽  
Juliette Brown ◽  
Laura Ralph ◽  
Alan Clarke ◽  
Tim Bhoyroo ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Length Of Stay ◽  
Older Adult ◽  
Average Length ◽  
Psychiatric Ward ◽  
Bed Occupancy ◽  
Care Needs ◽  
Bed Days ◽  
Community Team ◽  
The Impact

BackgroundLength of stay and bed occupancy are important indicators of quality of care. Admissions are longer on older adult psychiatric wards as a result of physical comorbidity and complex care needs. The recommended bed occupancy is 85%; levels of 95% or higher are associated with violent incidents on inpatient wards.MethodsWe aimed to reduce length of stay and bed occupancy on Leadenhall ward, a functional older adult psychiatric ward serving a population of just under 40 000 older adults in two of the most deprived areas of the UK.At baseline in October 2015, the average length of stay was 47 days, and bed occupancy was at 77%. We approached the problem using quality improvement methods, established a project team and proceeded to test a number of changes over time in line with the driver diagram we produced.ResultsIn 12 months, length of stay was reduced from an average 47 to an average 30 days and bed occupancy from 77% to 54%.At the end of 2016, the closure of some beds effected this calculation and we added an additional outcome measure of occupied bed days (OBD) better to assess the impact of the work. OBD data show a decrease over the course of the project from 251 to 194 bed days (a reduction of 23%).ConclusionThe most effective interventions to address length of stay and bed occupancy on an older adult functional mental health ward were the daily management round and the high-level management focus on longer-stay patients. The work depended on an effective community team and on the support of the quality improvement programme in the trust, which have led to sustained improvements.

scholarly journals Protecting the Health Service and Managing the COVID-19 Pandemic Surge: The Unintended Impact of Service Reconfiguration on the Specialist Rehabilitation Service at a Regional Teaching Hospital

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Cosgrove T ◽  
◽  
Salawu A ◽  
Keyword(s):  
Length Of Stay ◽  
Health Service ◽  
Discharge Destination ◽  
Bed Occupancy ◽  
Response Planning ◽  
Home Discharge ◽  
Comparative Review ◽  
Rehabilitation Ward ◽  
Specialist Rehabilitation ◽  
The Impact

As part of the UK National Health Service (NHS) preparations to manage the impact of the COVID-19 pandemic on hospital services, clinical guidelines that emphasized the expansion of the acute care capacity in managing the anticipated surge in COVID-19 cases were implemented. Clinical wards were reconfigured and routine face-to-face outpatient clinics were suspended. Some of the changes include workforce and facilities reorganization. One of the changes implemented at the Hull University Teaching Hospitals NHS Trust (HUTHT), was the relocation of the Complex Rehabilitation Ward from its 15- bed base in the Queen’s Centre for Oncology to a repurposed 12-bed surgical ward within the main Castle Hill Hospital (CHH) building in March 2020. Methods: A comparative review of the admissions and outcome measures data (admission diagnosis; referral source; PCAT: Patient Categorization Tool; LOS: Length of Stay; Bed occupancy and discharge destinations) over a 4-month period (March-June 2020) was undertaken and compared to retrospective data from a corresponding 4-month (March-June 2019) period in the previous year to determine the impact of the ward relocation on the delivery of specialist rehabilitation to patients with complex needs during the pandemic episode. Results: A reduction in total number of admitted patients (n=28 in 2019; n=18 in 2020) with reduced bed occupancy from 99% in 2019 to 72% in 2020 despite a reduction in bed base was noted following the ward relocation. A shorter length of stay with a mean of 29 days was noted following relocation of the ward while an increase in patient complexity as demonstrated by the PCAT scores was observed. The proportion of patients achieving a home discharge destination as opposed to other residential care facilities increased, accounting for 89% among discharged patients. Conclusion: This review demonstrated some of the impact of the measures implemented to combat the 1st wave of the coronavirus pandemic, specifically the relocation of the specialist inpatient rehabilitation ward in a tertiary hospital setting. Though a higher proportion of the admitted patients had increased complexity, a shorter length of stay with a significant proportion of the patients achieving a home discharge destination were observed following ward-relocation in 2020 compared to a similar quarter in 2019. The findings also reflected a reduction in bed occupancy despite reduced bed base capacity. Though there is a noted reduction in duration of stay in hospital and a greater proportion the patients achieved a home discharge destination, this was achieved with a compromise on the rehabilitation process due to the constraints of the new ward environment. Significant impact in the quality of the therapy programmes delivered was observed. The longer-term impact of this will need to be monitored. This review highlights the need for consideration of specialist rehabilitation as part of the acute response planning process in pandemic and mass casualty events.

Community care and old-age psychiatry

1992 ◽  
Vol 5 (4) ◽  
pp. 571-574 ◽  
Author(s):  
Chris Hallewell ◽  
David Jolley
Keyword(s):  
Old Age ◽  
Community Care ◽  
Old Age Psychiatry

scholarly journals Elder abuse and the community psychiatric team

1994 ◽  
Vol 18 (12) ◽  
pp. 730-732 ◽  
Author(s):  
Judith S. Kerr ◽  
Tom Dening ◽  
Claire Lawton
Keyword(s):  
Old Age ◽  
Elder Abuse ◽  
The Elderly ◽  
Community Psychiatric ◽  
Single Pattern ◽  
Old Age Psychiatry ◽  
Professional Responses ◽  
The Impact

To date, there are few reports on the extent of elder abuse among patients referred to old age psychiatry services. This study examined suspected cases of abuse among new referrals to a community psychiatric team for the elderly, at a time when guidelines and procedures for the detection and management of elder abuse were about to be introduced. of 74 cases assessed, seven (almost 10%) were probably being abused. Several types of abuse were described, with no single pattern, and the professional responses therefore needed to be flexible. The impact of introducing the guidelines win be assessed later.

Factors influencing maternal length of stay after giving birth in a UK hospital and the impact of those factors on bed occupancy

2008 ◽  
Vol 28 (1) ◽  
pp. 73-76 ◽  
Author(s):  
A. Elattar ◽  
E. M. Selamat ◽  
A. A. Robson ◽  
A. D. Loughney
Keyword(s):  
Length Of Stay ◽  
Bed Occupancy ◽  
Factors Influencing ◽  
The Impact
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