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Right Care Right Place Right Time - Frontline professionals delivering person-centred care
From Department of Health
Published on
Last updated on
From Department of Health
Published on
Last updated on
The 12th Sláintecare Right Care Right Place Right Time webinar took place on 23 September. We put the spotlight on frontline professionals that have been delivering innovations in person-centred care through the Sláintecare Integration Fund. Working in multidisciplinary teams has been key to delivering the innovations needed to deliver the Sláintecare Innovation Fund objectives.
This webinar featured three Sláintecare Integration Fund projects, all highlighting how frontline professionals can deliver excellent person centred-care.
70% of clinical decisions are made with access to laboratory results, and using traditional methods, this could often take three to four days. This was a very unsatisfactory turn around time for patients and staff.
The introduction of a molecular system has allowed for the rapid, cost-effective identification of pathogens responsible for enteric diseases and respiratory infections. The new Molecular Testing Platform has led to quicker testing turnaround times and improved diagnostics.
The project team Dr. Liz Fitzpatrick, Chief Medical Scientist Project Lead, Dr. James O’Connor Senior Medical Scientist, and Dr. Deirdre O’Brien, Consultant Microbiologist reacted quickly to the onset of the COVID-19 pandemic and began using their Sláintecare funded equipment to kick-off some of the earliest COVID-19 testing facilities. In 2020 the team tested over 20,000 COVID-19 samples, and in 2021 they have tested over 24,000 samples to date.
They reduced the COVID-19 test turnaround time from six days to six hours, an 83% reduction in waiting time for a test results.
The team also returned to testing non-COVID samples, and focused again on enteric diseases. These efforts allowed them to reduce the turn-around time for sample results, with a knock-on effect of increasing the amount of samples they tested. The team had aimed to provide testing for:
The team explained how the technology is of particular benefit to patients of Irritable Bowel Disorder and Chronic Obstructive Pulmonary Disease. The molecular platform helps facilitate timely treatment of patients, aids in the management of admissions and earlier discharge, and leads to improved patient outcomes. Results within hours aid in the differentiation between microbiological disease and sudden intensifications of symptoms associated with these chronic conditions and allow rapid, appropriate interventions.
The introduction of an Advanced Nurse Practitioner (ANP) in Cardiology and HF is improving patient access to HF clinics and services.
Karen Kelly, the Candidate Cardiology Advance Nurse Practitioner (cANP) explains how the team refer to themselves as the Heart Optimisation Team, and how they support the patient in their medication and optimising their quality of life. The patient is at the centre of everything they do and all the care is designed individually for each patient. They work with the patient and their families to make sure the patient has all the support they need to manage their condition at home, avoiding hospital admission and readmission.
This service includes a ‘Virtual Clinic’, where the ANP in cardiology works with the Consultant Cardiologist in providing outpatient care. A key component of this is a telemedicine service (Virtual clinic) providing diagnostic and management support for GPs. The service treats patients with low risk chest pain and palpitations, and will assess patients with HF and those who are at risk of HF.
Karen has streamlined care pathways which improves care for patients, and allows the team to see more patients. The team can see patients directly upon diagnosis, as well as receiving referrals directly from in-patients and the community. For this cohort of patients, readmission rates have reduced from around 60%, to zero readmissions since the beginning of the project.
Nurses also visit patients in their homes, to follow up on monitoring, and adjust medications. This was extremely valuable during the COVID-19 pandemic, and is still very much appreciated by patients. One patient in particular had an 80 kilometre round trip to attend clinic, and can now have their appointment without leaving their house.
Thanks to the successful engagement the team has carried out across different clinical teams in the hospital, patients can now see a number of specialities in one visit, without having to come to hospital multiple times for tests and treatments.
Patients are extremely positive and satisfied with the service, and feel more confident managing their health and condition. This is with the assistance of a remote monitoring service, where patients can monitor their blood pressure and weight at home. Patients and their families are also included in an education programme.
Karina Somers, Registered Advanced Nurse Practitioner, Frailty/Older Persons and Aideen McGuinness, Senior Dietitian.
Wexford General Hospital (WGH) and CHO 5 South East Community Healthcare are integrating acute and community older people services with their project Age Related Care (ARC) Team. With a team including, an Advanced Nurse Practitioner, a Senior Dietitian, a Medical Social Worker, a Senior Occupational Therapist, Senior Physiotherapist, they can integrate services, and give patients a route to make their care pathway more straightforward.
ARC provides Comprehensive Geriatric Assessments for older people who are referred to the service by the acute hospital as well as through community health services. The project hub is based in the day hospital in WGH, and streamline their work across the acute and hospital settings through standardised documentation, information and communication.
Like a lot of services, ARC experienced disruption due to COVID-19, however they used some of these challenges to their advantage. Phone discussions in advance of appointments to screen for COVID-19 reduced fear amongst their patients and increased attendance. As a result of social distancing guidelines, groups sizes for classes and other activities are smaller, which helps patients feel more comfortable, and allows them to get to know their doctors, nurses and therapists better.
Results of this project have been great for team members and patients, most of whom now get an appointment for a full geriatric assessment within two weeks. This can be a long appointment, but it allows patients to access a range of services in one visit, avoiding multiple trips to hospital, and it reduces waiting times for individual services.
ARC has been successful in securing long term funding through the Enhanced Community Care fund, meaning that patients will be able to access these comprehensive services on a long term basis. The aim of the team is to expand their services in to four further locations in the county so that patients can have their appointments locally, and be able to provide home visits, really providing the right care in the right place at the right time.