What is the challenge your project is going to address and how does it connect to the theme of 'How can we improve across system boundaries?​

Reablement support workers will help to promote physical activity and functional independence with patients in the acute setting.

We predict that patients will become more independent and confident in their functional abilities post-acute illness.

We think that introducing patients to reablement whilst in hospital will reduce their hospital length of stay, but also improve patient confidence in services and support on discharge. We hypothesise that patients that receive reablement whilst in the hospital setting will require less support on discharge and then reduce their services earlier once home and in the community, this will improve system capacity for packages of care.

What does your project aim to achieve?

We aim to:

• improve patient confidence in their own functional ability whilst in hospital
• improve staff confidence in patient’s functional abilities in the hospital setting
• reduce level of care support needed at discharge
• reduce length of time reablement care support is needed once home
• improve patient confidence and reduce fear of going home-at point of discharge

How will the project be delivered?

We have close working relationships across our Newcastle system and meet regularly with system partners.

We would start by hosting stakeholder meetings to determine expectations and ensure all the right people and partners are involved or informed of the project. We would also involve our patient experience team to ensure that patients were able to co-design and inform on this project.

During this time we would be collecting data (if not already available) to inform a baseline of our intended outcomes as outlined above.

We will then identify an acute ward to host the pilot. Then with system partners and ward leaders develop job roles, job descriptions and address any operational barriers.

Once started there will be an active data collection period with regular communication with all staff involved to ensure any issues are resolved or successes celebrated in a timely fashion.

How is your project going to share learning?

Whilst operationally we work closely with system partners clinical teams often remain in silos. This is an opportunity to pilot true integrated system working and experience shared learning and working for the benefit of our patients. if successful we hope that this may help other localities improve patients’ outcomes, staff confidence, and patient flow.