This award rewards those NHS organisations who have successfully implemented initiatives that have enabled them to reduce readmissions or improve the safety of discharge from one area of care to another.
An analysis of the impact of intramuscular antibiotics for the treatment of severe-borderline foot infections in diabetes: an admission avoidance strategy
Norfolk & Norwich University Hospitals NHS Trust
Research by NHS Diabetes has shown that the most frequent cause of diabetes-related hospital admissions is conditions affecting the foot. To address this, Norfolk & Norwich University Hospitals NHS Trust felt that some infections could be safely treated at home, with once daily intramuscular antibiotics administered by practice or district nurses, rather than in hospital. During the first 22 months of using the protocol, of the 26 episodes treated, 14 people required no admission at all, and of the remainder, their length of stay was significantly shorter than those people who required immediate hospital admission. In the first 22 months of using this approach, over £62,000 was saved by avoiding, or shortening hospital stay.
"A fabulous initiative, clever, brilliant, with real cost savings in context of antibiotic overuse."
Management of Raised Glucose (MoRG), A Clinical Decision Tool
Royal Surrey County Hospital
Many physicians have limited experience and confidence in diabetes early discharge, and the safest option is often to admit patients for specialist diabetes review as inpatients regardless of whether or not this is needed. To address this, the diabetes specialist team at Royal Surrey designed a tool to help non-diabetes specialists identify those patients who could be safely discharged and managed at home. The Management of Raised Glucose (MoRG) clinical decision tool consists of an algorithm that guides physicians through the patient assessment. It can be safely used by non-specialists, and it aims to improve the quality of assessment, aid safe early discharge, and improve patient care whether patients remain in hospital or not. It has also been shown to lead to a reduction in inappropriate intravenous insulin infusion use and improve patient satisfaction.
Admission Avoidance – telephone helpline
Anglian Community Enterprise CIC
The North East Essex Diabetes Team set up a telephone helpline service, which involved a senior DSN or consultant being immediately available to answer queries from primary care HCPs. The helpline was available to give advice from 8am-8pm, and DSNs can arrange to see patients who would otherwise have been admitted to hospital. This review of patients took place in a clinic or their home environment. Each patient was followed up by the service the following day and then referred on to the appropriate service to continued management. The helpline resulted in a reduction of 41 admissions over 6 months and provided essential data for the future planning of the service, which is shortly to be fully commissioned.
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