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What is the challenge your project is going to address and how does it connect to your chosen theme?

Barnet Hospital has a high population of elderly and frail patients. These patients are often complex in nature and requiring increased support for discharge from the hospital. There are many initiatives in the community which support admission avoidance but few which expedite discharge once the patient is admitted. Length of stay of frail elderly patients can be long due to difficulty in getting the right support in place or the right discharge destination. Barnet Hospital has a high number of stranded patients and work is being undertaken to try to reduce this figure in line with national initiatives.

What does your project aim to achieve?

The aim is to have a therapist working as part of the complex discharge team, providing expertise for the management of complex discharges, coordinating with ward therapists and hospital management to support early discharge and reduce length of stay. The role of the therapist would be to review appropriate patients in the community at or after discharge, ensuring the discharge provisions are suitable and troubleshooting if necessary, to prevent readmission. The therapist would liaise with both acute and community services prior to and after discharge to support the transition.

How will the project be delivered?

A therapist will be recruited to the discharge team, reviewing patients which have complex therapy needs, working closely with the hospital therapy team and community services, social services and primary care whilst providing the support that the complex discharge team provide. The therapist will play a key role in communicating with the wider team, attending MDTs, liaising with community providers and follow the patient home to ensure appropriate support is in place.

What and how is your project going to share learning throughout?

This can be presented at Frailty network events, appropriate conferences, GIRFT, other networks such as the society of acute medicine. It can also be shared with other AHPs in the NCL or wider areas as those forums are already in place.

How you can contribute

  • Has anyone tried something similar before?
  • What were the major pitfalls?

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