tele-healthcare in wolverhampton - amazon web...
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Tele-healthcare In Wolverhampton
Angie Beards – Service Development Manager,Adult Community Services.
Della Smart – Acting Lead Nurse, Community Matrons’.
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“A combination of equipment, monitoring and response that can help individuals to remain
independent at home”
(DOH 2006)
Tele-healthcare What is It?
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• Overview of Wolverhampton.
• Community Matron Service.
• Integrated working.
• Where are we now.
• Vision for the future.
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Where are We
• North end of the West Midlands.
• 15 Miles North West of Birmingham.
• 75 Miles south of Manchester.
• Boarder South Staffordshire and Shropshire.
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Who Are We?• Population of 266,614.
• Average of 9000 people living per sq. mile.
• Ranked twenty-eighth most deprived out of 354 local authorities with some areas ranked at 5.
• In bottom 5th for life expectancy and deprivation indicators.
• 20% of the population have a long-term limiting illness or disability.
• COPD and heart failure prevalence higher than national average.
(Wolverhampton Joint Strategic Needs Assessment 2008)
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Community Matrons Team
• 9 Matrons & clinical lead.
• Advanced health assessment skills.
• Long term condition training.
• Prescribing.
• Innovative trainee matron posts.
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• Proactive case management approach.
• Tiered approach.
• Collaborative working.
• Tele-healthcare.
• Personalised Management Plans.
• Utilise predictive risk data.
Principles of the Service
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LTC Management and Shared Care
case
management
disease/care
management
self care
support/
management
level 3high complexity
level 2high risk
level 170-80% of
CDM
population
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• Self-management.
• Supported self-care.
• Shared decision making in care planning.
• Empowered and educated individual.
• To prevent avoidable hospital admission.
Aims of the Service
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• Provide expert assessment, diagnosis, treatment and referral.
• Develop individualised plans of care in discussion with patients and carers.
• Educate and empower individuals to recognise signs of deterioration.
• Ensure regular reviews and a rapid response.
• Regular review of medications.
Role of the Matron
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Integrated WorkingInitiation
• 2006 – Wolverhampton City Council, (WCC) using funds from their Preventative Technology Grant, purchased 10 telehealth monitors.
• Approached Wolverhampton City PCT (WCPCT) to set up a telehealth pilot.
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Integrated WorkingPilot Development
RolesWCC
• WCC’s Telecare Service managed the equipment which included storing the monitors, installations, removals, decontamination, general maintenance and returns to providers (not Honeywell at this time) if required.
• Monitored alerts on Lifestream using a stand alone BT line at WCC’s Carelink centre and reported to the Community Matrons as per protocol.
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Integrated WorkingPilot Development
RolesRoyal Wolverhampton Hospitals Trust (RWHT)
• Undertook annual testing (Calibration, PAT etc).
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Integrated WorkingPilot Development
RolesWCPCT
• Identified appropriate patients for telehealth.
• Managed patients within service protocols.
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Integrated WorkingPilot Outcomes
• The technology was well accepted by users who overall felt confident and reassured by using this technology.
• All users were capable of performing the necessary tasks to permit the transmission of data.
• There were no issues of breaches of confidentiality in relation to the data during the project period.
• An extremely positive outcome of the project was the joint working achieved between the organisations involved.
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Where Are We Now?
• July 2009 employed Tele-healthcare Lead.
• Tele-healthcare Strategy Produced.
• Tele-healthcare Business Case Submitted.
• SLA between RWHT and WCC in operation.
• 61 monitors now available to RWHT community services.
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Where Are We Now (cont) ?
Monitors used to support;
• Avoid unnecessary exacerbation/deterioration of the patients disease.
• The prevention of avoidable hospital admission.
• Support preferred place of care i.e. living at home.
• Patient education.
• Supporting carers.
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Where Are We Now (cont) ?
• Minimise the medical and social impact of a patients condition.
• Case load management.
• End of Life Care.
• Monitors used in Residential Homes and Nursing homes.
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Benefits of Tele-healthcare
To the individual:
• To assist people to stay independent.
• To build confidence, reassure them and support the self- management of their long term conditions.
To the Community Matron:
• Workload planning.
• Helps to achieve specific targets of reduction in unplanned hospital admissions.
• Evaluate and plan care.
• Trend monitoring.
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Patients monitored2008-2009 42
2009-2010 70
2010-2011 127
2011-2012 45 (April & May)
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0
2
4
6
8
10
12
14
16
18
Was the equipment easy
to use?
The instructions were good and I felt confident to
use the equipment
Taking the daily recordings made me feel confident
and more in control of my
condition
Taking the recordings made
me nervous
I felt able to contact the
clinician if I had a related problem
I would use the monitor in the
future if suggested by a
healthcare professional
Agree
Somewhat agree
Disagree
Patient Satisfaction Survey 2010-11
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Shared Vision for the future
• Joint Tele-healthcare Service.
• Every patient with a Long Term Condition/impairment is considered for tele-healthcare.
• Tele-healthcare is considered earlier in the patients journey e.g from diagnoses, to help them live healthier for longer.
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Absent FriendsWCC Telecare Team
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Reference
Department of Health (2006) Supporting People With LongTerm Conditions to Self-care. A guide to developing local strategies and good practice. DOH London. http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4130868.pdf: accessed 9/3/201.
Wolverhampton Joint Strategic Needs Assessment (2008)
http://www.wolvespct.nhs.uk/Library/Documents/Publications/JS
NA%20March%202009.pdf: accessed 11/2/2010.