\n The day starts with patient visits:\n<\/p>\n
\n It\u2019s just after 8am on Tuesday 9 December and the Admission Avoidance team are already out across Bolton to visit patients who require their help.\n<\/p>\n
\n Georgina Follows is an Advanced Clinical Practitioner who has been out to see an elderly patient that\u2019s recently returned to a care home after a hospital stay.\n<\/p>\n
\n Georgina explained how she was able to provide an assessment there.\n<\/p>\n
\n She said: “At the end of October she was treated for a chest infection with antibiotics via the GP, but unfortunately didn\u2019t get better and was admitted to hospital at the start of December.\n<\/p>\n
\n \u201cI went to see her for a post-discharge review. She\u2019s completed her antibiotics but still doesn\u2019t feel very well. Her chest is still making some low basal crackles and I believe she still has a chest infection.\n<\/p>\n
\n \u201cGiven her age and the fact we want to keep her out of hospital, it\u2019s appropriate we give her more oral antibiotics and we\u2019ll have some advanced care planning discussions with the family so that we can treat her in the community as best we can.\u201d\n<\/p>\n
\n Reviewing patient care\n<\/p>\n
\n By 11.17am, Admission Avoidance have 22 patient reviews and nine new assessments.\n<\/p>\n
\n All of this activity is helping to keep people away from hospital.\n<\/p>\n
\n To support, a safety huddle is underway to see which patients require care support so they continue to receive treatment in the place they call home.\n<\/p>\n
\n Just twenty minutes later, a team made up of pharmacists, consultants, clinical practitioners, and advanced clinical practitioners are meeting to review patients on the frailty virtual ward.\n<\/p>\n
\n It\u2019s here where they discuss care management plans, review patient medication, agree assessments and plan discharges, whilst setting actions and linking in with local partners, such as GPs and social care.\n<\/p>\n
\n Providing support to the Emergency Department\n<\/p>\n
\n At midday the team receive a call from the Emergency Department at Royal Bolton Hospital, which is facing extreme pressures as patients experience long waits for both assessment and treatment.\n<\/p>\n
\n This is being largely driven by a high number of attendances and an influx of patients with flu-like symptoms.\n<\/p>\n
\n To provide support and ease pressure, Admission Avoidance are looking at what calls they can pick up to deliver care in the community and deflect people away from hospital.\n<\/p>\n
\n Patient visits\n<\/p>\n
\n After lunch, Advanced Clinical Practitioner, Jamie Fletcher, is visiting Ann, 87, at her home in the borough as part of the Hospital at Home service.\n<\/p>\n
\n After recently leaving Royal Bolton Hospital, Ann was referred as a follow-up with Admission Avoidance by being placed on a Virtual Ward, where she can continue to receive care from the comfort of her own home.\n<\/p>\n
\n Jamie said: \u201cWe\u2019ve been out to see Ann a few times to make sure she\u2019s comfortable and recovering well. Ann\u2019s had a lot of inputs from our geriatricians, from the Advanced Clinical Practitioners like myself, Clinical Practitioners and pharmacists and other members of the multi-disciplinary team.\n<\/p>\n
\n Ann\n<\/p>\n
\n \u201cSince we’ve been involved with Ann over the past few weeks, she’s not had any further admissions to hospital and we’ve managed to keep her comfortable and safe in her own home. This means she hasn\u2019t needed to go back to the hospital.\u201d\n<\/p>\n
\n Speaking to Jamie during the home visit, Ann said: \u201cI’m still shaky, but I’m feeling much happier being at home and more confident that I will get better. I\u2019m improving day by day.\n<\/p>\n
\n \u201cAll of my care was put in place which includes calls in the morning to see how my blood pressure was to medication, which I worried about getting the right tablets. They sorted all that and took all that stress off me and it was lovely being at home. I really feel I will recover a lot quicker.\n<\/p>\n
\n \u201cI felt very safe. I was still being monitored and looked after and there was always a phone number I could ring if things got worse.\n<\/p>\n
\n <\/p>\n
\n \u201cIt was lovely to be with my family. I’m on the mend. I’ve found all of the Admission Avoidance team a godsend, really.\u201d\n<\/p>\n
\n Urgent Community Response\n<\/p>\n
\n As Jamie was with Ann, he received a referral from the clinician at North West Ambulance Service, who are embedded within the Admission Avoidance team. It was for a 2-hour Urgent Community Response call, which aims to provide care to people in their homes within two hours and helps to avoid hospital admissions.\n<\/p>\n
\n After taking the call at 2.15pm he was with the individual within 45 minutes and provide a medical assessment.\n<\/p>\n
\n Jamie explained: \u201cThis referral was for an 82-year-old woman who has dementia and her carers expressed concern following a visit this morning as the lady complained of pain and wasn\u2019t her usual self.\n<\/p>\n
\n <\/p>\n
\n \u201cI\u2019ve been in to assess her and she has a high temperature. It\u2019s quite a complex case because she has dementia and wasn\u2019t able to provide her medical history. To make sure she\u2019s safe and well, I\u2019ve liaised with the carers and her family and we\u2019ve agreed a management plan, taken some bloods and we\u2019ll be seeing her on a daily basis over the next few days.\n<\/p>\n
\n \u201cThanks to this service it means patients, like this, are able to stay at home with their routine and people they know and avoid needing to visit or stay in hospital.\u201d\n<\/p>\n
\n For more information about services provided by Bolton NHS Foundation, please visit their website.<\/p>\n","protected":false},"excerpt":{"rendered":"Bolton NHS Trust, which runs Royal Bolton Hospital, has an Admission Avoidance Team, which help 400 people every…\n","protected":false},"author":2,"featured_media":343180,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[43],"tags":[102,2960,56,54,55],"class_list":["post-343179","post","type-post","status-publish","format-standard","has-post-thumbnail","category-healthcare","tag-health","tag-healthcare","tag-uk","tag-united-kingdom","tag-unitedkingdom"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/343179","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/comments?post=343179"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/343179\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media\/343180"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media?parent=343179"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/categories?post=343179"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/tags?post=343179"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}