Greater Glasgow Integrated Discharge Manager
Summary of Initiative
Aims and Objectives
- Provide a whole systems approach to discharge management for all patient groups within Glasgow acute hospitals.
- The integrated structure ensures smooth and seamless patient journeys, minimising gaps and delays and providing clarity of roles within the single team framework.
- Improving and monitoring performance across the raft of discharge cativity.
- Providing appropriate admissions avoidance, early and supported discharge services, particularly to older people.
When was it established
- Integrated discharge management was established in 2004
- IRIS - Interdisciplinary Response & Intervention Service - which provides appropriate admission avoidance and early supported discharge was established in 2002.
- DART - Discharge and Rehabilitation Team established in 2003
- OHPAT - Out Patient and Home Parental Antibiotic Therapy Service established in 2001
- Acute Hospital Homeless Liason Service extablished in 2004
The initiatives were developes through the Joint Planning processes involving health and local authorities.
Potential Benefits
- IRIS provides appropriate admission avoidance by GP rapid response, discharge from A&E.
- IRIS & DART provide early supported discharge from in-patient areas targeting vulnerable older people.
- Delayed discharge numbers reduced after the establishment of the service.
- OHPAT provides an alternative to in patient care for patients requiring intravenous antibiotic therapy and has a significant impact on the length of stay for patients included.
- Acute hospital homeless liason service provides a structured link back to the community services for homeless people attending or being admitted to hospital.
Techmology
- A joint integrated care pathway is utilised within IRIS and a database has been set up to report jointly on health and local authority information for ISD.
- IRIS & DART staff can order equipment from GGILES - Greater Glasgow Independent Living Store website.
Results
IRIS admission avoidance from April 2005 to March 2006 - 533
Supported discharge from April 2005 to March 2006 - 2,050
DART early supported discharge from April 2005 to March 2006 - 765
OHPAT April 2005 to March 2006, total patients referred - 404
- 306 patients referred for IV antibiotics, of these 289 were included
- 98 patients referred for IV access
- Total avoided admissions - 135
- Total bed days saved - 4,196
- Total bed days saved since 2001 - 19,112
Since the introduction of IDM delayed discharges have reduced from April 2004 (267) and exceeded the April 2006 target of 80 patients across Glasgow delayed for more than 6 weeks. Actual figure was 77.
Further Information
Should you require any further information on this initiative please contact Joyce Brown ( joyce.brown@northglasgow.scot.nhs.uk) or Dot Jardine ( dot.jardine@sgh.scot.nhs.uk).