Review of acute hospital services in the Mid - Health Service Executive

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Alternative Care Setting Proportion of inappropriate admissions Review of acute hospital services in HSE Mid-West An action plan for acute and community services 43 Proportion of patients whose length of stay could have been reduced None or not specified 18% 17% General Practitioner 12% 11% Home with support 19% 22% Home Care Packages 3% 0.3% Non Acute Bed 3% 7% Non Acute Bed & Therapy 9% 21% Hospice 3% 0.3% Mental Health Bed 0% 1% Diagnostics/Assessment 33% 21% Total 100% 100% Source: Based on information contained within the National Acute Hospital Bed Use Review, 4 May 2007. For inappropriate admissions, 18% required no alternative service and a further 12% required access to the normal services of a GP. A third of inappropriate admissions required access to diagnostics and assessment outside of the acute hospital setting, with the remainder of patients requiring alternative bed based support or home care support. For those patients whose length of stay in an acute hospital could have been reduced, 17% required no support and could have been discharged immediately, and a further 11% only required access to the normal services of a GP. For those patients who required additional support following discharge from the acute hospital, 28% required access to a non-acute bed either with or without therapy services, just over 22% required home care support or a Home Care Package, and 21% required access to diagnostics and assessment outside of the acute care setting. We have taken these findings of the alternative care settings from the Acute Hospital Bed Review and applied them to the number of patients that we identified for admission avoidance and earlier supported discharge, (modelled to 2010), by applying our best practice assumptions. Our analysis has identified 4,586 patients whose admission to an acute hospital could have been avoided, and 8,717 patients whose care could qualify for earlier supported discharge. Having identified the number of patients requiring access to services in primary and community settings, we have converted this into appropriate capacity requirements for avoidable admissions (Table 8) and earlier supported discharge (Table 9). The outcomes have been subsequently reviewed and agreed with Local Health Managers of the Primary, Community and Continuing Care Directorate of the HSE Mid-West 33 . 33 Workshop convened on 19 th June 2007 with Mid-West LHO managers.
Key findings from the analysis are: Review of acute hospital services in HSE Mid-West An action plan for acute and community services • 33% (1,513 patients) of avoided admissions and 21% (1,831 patients) of supported earlier discharges requiring access to diagnostic services through primary care services; • 3% of patients (138) avoiding admission to regional hospital services requiring home care packages; • Less than 1% of patients (29) being discharged earlier from regional hospital services requiring a home care package; • The remainder of patients avoiding admission to, or being discharged earlier from, regional hospital services requiring support either through the specialist skills of the Primary Care Teams and wider network support, or a stay in a rehabilitation/community support bed; and • On average, the length of stay for rehabilitation/community support would be up to four weeks, given the range in intensity of care required. Admission avoidance The estimated impact of the additional home care packages, patients supported by PCTs and rehabilitation/community support beds relating to admission avoidance is presented in Table 8. Table 8: 2010 Impact on PCCC from admission avoidance (4,586 patients) Resource type Proportion Patients Assumption Resource quantum None or not specified 18% 825 None 0 44 Resource currency
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Current service delivery Regional s
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Consultant Medical Workforce Review
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Future clinical model of care Revie
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The patient at the local ‘centre
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Centralising specialist acute servi
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Specialty British Columbia 100 New
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Critical care network Review of acu
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Tele-medicine Review of acute hospi
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Review of acute hospital services in the Mid - Health Service Executive

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