St Helens – Using telehealth as part of an effective reablement service
“Telehealth has really helped me prioritise patient care; I can log on any time to access the information and see straight away if the observations are indicating that I need to go out to see someone.
I used to go to the reablement unit every day but now I don’t feel I need to and that’s freed my time to make more community visits. Telehealth has given me the flexibility to be more responsive to patients’ needs, and its empowering them to take more responsibility for maintaining their own health stability.”
Ann Hughes, Reablement Nurse, Bridgewater Community Healthcare NHS Trust
St Helens Council and Bridgewater Community Healthcare NHS Trust have been using telecare and telehealth to support people with long-term health and care needs for some time, including the services as part of packages of care to help to increase independence and safeguard service users. In June 2013, the Adult Social Care and Health team, in partnership with Environmental Protection Careline services, commenced a year-long pilot project to assess the benefits of including telehealth as part of its Reablement Service.
The Reablement Service aims to:
- Help people to remain at home and be independent as possible
- Prevent unnecessary admission to hospital
- Help people recover faster from illness
- Support discharge from hospital
- Prevent unnecessary admission to long-term care homes
The initiative has been developed by a multi-disciplinary team including staff from St Helens Careline, nurses from Bridgewater Community Healthcare NHS Trust and the Reablement Service. The Reablement Service offers support in the community and at a 5 bed facility located with
Brookfield Residential Home to help people return home after a stay in hospital and regain their independence. The service is delivered by social care and clinical staff, including experienced Social Workers, Occupational Therapists, Nurses, Physiotherapists, Technical Instructors, Community Psychiatric Nurses, Assistant Practitioners and Intermediate Care Support Workers.
Referrals are received from the Integrated Hospital Assessment Team (ICAT), based at Whiston Hospital and include adults who need guidance on managing long-term conditions such as diabetes or Chronic Obstructive Pulmonary Disease (COPD).
The reablement unit at Brookfield has a myclinic multi-user telehealth system, which is used to record the vital signs of patients daily. These readings can include blood pressure, weight, temperature and blood oxygen levels depending upon the condition being monitored. Results are transmitted to St Helens Careline for triage, and verified readings outside the parameters set for the individual patient will raise an alert prompting Careline staff to take appropriate action. Community matrons can also log into the system remotely at any time, helping to inform the ongoing care plan and highlighting any cause for concern at an early stage.
Patients generally use the Reablement Service for a 6-8-week period, which often combines a stay at Brookfield with follow-on support in the community. Patients with long-term conditions may then be offered the use of one of five mymedic telehealth systems to monitor their signs and symptoms at home.
- Community Matron saved 2 days each week, visiting reablement unit
- Early intervention enabled
- Patient experience improved
- Integrated working supported
Using telehealth managed by Careline as part of the Reablement Service enables clinical and social care staff to monitor the progress of patients, and intervene at an early stage if a possible problem is detected, preventing deterioration and possible re-admission to hospital.
Integrated working is also supported, as staff from health and social care liaise daily and have access to the same, up-to-date patient information.
An issues log has been kept which has enabled the few that have arisen to be dealt with promptly.
Using the myclinic system has enabled community matrons to monitor results remotely, saving approximately two days each week visiting Brookfield, time which is now spent supporting patients in the community.
All patients have been issued with pre-and post service evaluation forms to enable evaluation of the pilot upon its conclusion in June 2014. This will form part of the Council’s decision making process when it considers whether to extend the use of telehealth to other residential care
homes and day centres in the borough.
Solutions for health
Connected Health is a model for the delivery of healthcare that includes technology in pathways to help make more efficiency use of resources, by enabling healthcare to be provided in the community and empowering patients to take an active role in managing their own health.