Search

Background The Occupational Therapy (OT) service in the integrated care HUB team was established in January 2018. Prior to this, there was an established memory clinic, however with inconsistent access to OT. The streamlining and structuring of memory clinics further highlighted the need for post-diagnostic support for example individual sessions focusing on memory education and practical strategies to enable independence in daily activities. The integration of OT enabled person-centred strategies to be provided to individuals experiencing memory loss. Methods A retrospective analysis was completed comparing the number of OT memory patient contacts between January to June 2018 and November 2018 to April 2019 also reflecting the memory care pathway developed during this period. OT assessed all new patients experiencing memory difficulties that impacted on functional activities to initiate referral process. In April 2018, the Memory Technology Resource Room (MTRR) opened and the OT HUB using to facilitate patient contacts. The design/implementation of cognitive rehabilitation groups in May 2018 added another step to pathway. Dementia cafés were established in public cafés in the city and county area, sponsored by local care provider, also supported by HUB team. Feedback was gathered from surveys given to individuals, carers and HUB team in the Café and MTRR. Results From January to June 2018 there were 50 memory streamed patient contacts completed by the OT. From November 2018 to April 2019, 206 patient contacts were completed. These include both individual and group cognition focused sessions. Positive qualitative feedback was retrieved from attendees to MTRR and Café all indicating at least one positive outcome from post-diagnostic supports and services. Conclusion A multi-domain cognitive OT service when initiated by an integrated care HUB proves to be an effective and acceptable memory care pathway. The development of this holistic pathway enabled the person to be seen in the right place, at the right stage of their journey with memory difficulties. [ABSTRACT FROM AUTHOR]

Background The Inpatient rehabilitation service serves a population of 116,176 of whom 17,371 are aged 65yrs and over. Access to these units was traditionally via referral from the acute hospital sector with the minority of referrals coming from the community. Review of the existing rehabilitation pathway was undertaken and highlighted barriers of access to appropriate in-patient rehabilitation. The referral criteria were revised and an updated pathway was devised. Methods A quantitative retrospective review of all referrals received in four timeframes, commencing 1st July 2017 to date, was carried out. Each referral was classified into four subgroups: (1) Immediate Crisis (2) Emerging Crisis (3) Stable but Needs Optimisation (4) Stable and No in-patient Intervention required. The origin of the referral was also categorised into four subgroups: (1) Day Hospital (2) GP (3) AHP (4) Other. The Average Length of Stay (AvLoS) was calculated for, acute and community admissions, for each period breakdown. Results We compared 1st July 2017 to 31st December 2017 pre-establishment of the new referral pathway and the same six month period in 2018 post-establishment of the pathway. The new streamlined pathway facilitated improved access to in-patient rehabilitation from multiple sources and resulted in an increase in referrals from 25 to 79. Waiting time for admission was reduced from 37 days to 5 days. Community admissions increased from 16 to 48. There was no difference in AvLoS between the two time periods: Acute 22 & Community 17 to Acute 22.25 & Community 18. Conclusion This work highlights the effectiveness of an improved co-ordinated referral pathway, within an integrated care hub, from community to in-patient rehabilitation beds with improved accessibility and reduced waiting times. AvLoS figures suggest that appropriate patients were admitted to the rehabilitation units. Also, it confirms the efficiency of a patient centred approach in maximising appropriate services for Right Person, Right Place, Right Time. [ABSTRACT FROM AUTHOR]