Hilton Nursing innovates its patient hospital discharge service, Home to Decide, to help patients avoid the risks of catching or transmitting the coronavirus.
Patients assessed in hospital as medically fit for discharge, but requiring residential care, are now able to avoid a care home setting and return to the comfort and safety of their own home.
By avoiding a discharge from hospital into residential care patients not only avoid increased exposure to the dangers of the disease, but also get to decide if residential care can be avoided all together by recovering to independence under home based professional supervision.
Vital in aiding recovery is the use of monitoring technology. The technology assists the Hilton Nursing team by providing real-time, factual accounts of whether a discharge patient really is ready to be back in his or her own home.
John Taylor, operational lead at Hilton Nursing Partners Says: “We are very aware that after most acute hospital admissions a patient’s physical and emotional wellbeing can be vulnerable. This has increased hugely during the pandemic; people are scared and worried about their safety. It’s not only critical to manage the transition safely, but critical our patients are well cared for with the same high standards of care. The last thing we want is a backwards step and re-admission into hospital.”
Becoming enabled in ones own home is a delicate journey for anyone who has had a lengthy hospital stay, but Hilton Nursing’s process of reintroduction to home life is about building physical and mental confidence in patients.
The first step to becoming enabled is home support that allows patients to embrace the surroundings, and routines lost, whilst in hospital. Whilst happy to be at home, patients can often feel their independence is limited by the presence of a stranger spending lengthy periods of time in their home.
Mitigating this, Hilton has introduced the use of unobtrusive monitoring technology. The technology allows assessors to observe and assess patient recovery during times of the day when they are unsupervised.
Astonishingly the data feeding back to Hilton has shown patients are much quicker to recover as they return to their usual home routines.
John leads on to say: “Just to put this into perspective. We are not substituting technology for professional support and care; rather, we are evolving new ways to aid our support and recovery delivery. When supporting a patient back into their home environment it is very time intensive and involves support throughout the night. Regardless of how good a patient carer relationship is we have found some patients find it difficult to fully relax with this level of intrusion.”
Using technology to monitor the level of care and support needs helps the decision making process to determine if a patient does or doesn’t require residential care.
Through the use of motion sensors Hilton can receive feedback on whether the home is too hot or cold, if a tap has been left on, if a door has been opened and left open, if the patient is sitting in the same chair too long, how many times they get out of bed on a night. The technology is bespoke and set up to monitor a patient where Hilton Nursing and the patient’s family feel they could be most vulnerable.
John explains what this means in practice: “The data is providing facts about whether a patient is fit to live at home independently. One recent example is a patient who couldn’t be admitted to a care home due to the pandemic crisis. The only option was to return home. The patient didn’t want us in his home but thankfully we didn’t have to because the technology allowed us to monitor his capacity to be at home alone. It’s a real success, from someone on his way to a care home, he’s now back at home and fully independent and that’s where he’ll stay. That’s a result we are very proud of.”
The technology also helps with enablement. Visits to the bathroom at night are aided by the lights turning on automatically to increase visibility. If a room gets too hot a fan will automatically start. If a patient doesn’t get out of bed at the usual time Hilton Nursing and family are alerted, and if the patient needs help they can use their Hilton prescribed Amazon Echo to call Hilton Nursing for help.
John continues: “To say patients are better enabled towards independence is an understatement. We now have known facts about the patient’s routine whilst Hilton staff are not with them. This has provided a lot of comfort for family members anxious about their relatives been home alone. It has also helped to dispel assumptions relatives can make, such as ‘she falls a lot’, ‘he can’t manage bathroom activities on his own’. There are no assumptions with this technology. We know for a fact if a person falls a lot, we know if they struggle in the bathroom, the data lays all the facts out and confirms or denies these assumptions. If anything it’s a tool in helping families with their peace of mind and anxiety knowing their loved ones are safe.”
But without the technology it could be a very different story.
The government Guidance ‘Falls, applying all our health’ states that: ’The Public Health Outcomes Framework (PHOF) reported that in 2017 to 2018 there were around 220,160 emergency hospital admissions related to falls among patients aged 65 and over, with around 146,665 (66.6%) of these patients aged 80 and over’ 1
In most cases a fall is when patients end up in hospital. A one-off stumble that has rendered the patient quite helpless until the ambulance arrives is usually the beginning of a lengthy hospital stay. Quite often this leads to recommendations and assessments that deem that individual no longer having the ability, or capacity, to live at home safely independently.
John says: “This technology provides an assessment safety-net based on real-time data making it much easier to help patients plan for their future. Whether that is a residential care home or their own home, we can now confirm an individual has the capacity to be in their own home if they so wish.
The benefit of the technology speaks for itself. Hilton Nursing reports quicker patient recovery time and quicker discharge from their service as a result of real-time assessment.
John Taylor, operational lead concludes: “These are really positive outcomes. We are reducing intervention from other social care services, saving the NHS the cost of bed blocking, and saving the council the cost of funding social care. Our staff really enjoy using the technology, our patients are enabled without interruption to their routine, and patients relatives are comforted by having real peace of mind their loved ones are safe.
Currently Hilton Nursing has installed 12 monitoring systems across patient homes in Kent and Kingston and continuing to roll-out the technology across additional sites. To date 10 patients discharged from hospital into Hilton Nursing care have avoided care home placement, two of which have become fully independent requiring no package of care or enablement at home service.