Discharge to Assess
A new approach to reduce the number of people being delayed leaving hospital and maximise their ability to live independently at home, has been approved by the Moray Integration Joint Board (IJB).
Discharge to Assess supports the rapid discharge of people who are medically ready to leave hospital and appropriate to have their functional needs assessed among the familiar surroundings of their own home.
It is widely recognised that staying in hospital for longer than necessary has a negative impact on older people in particular. Ensuring that people receive the support they need to continue their lives at home is vital for their longer-term health and wellbeing.
Discharge to Assess supports patients through comprehensive physiotherapy and occupational therapy assessment and the provision of timely rehabilitation to maximise their independent living skills. The targeted functional approach results in more people remaining independent after a hospital admission or attendance, and a reduced dependency on formal care services.
Funding of £500,000 for 2021/22 to scale up the Discharge to Assess team was agreed by the IJB meeting on 25.03.21 following consideration of a report on the success of a test of change. Evidence was presented by project lead Dawn Duncan, Professional Lead for OT, of improved patient outcomes, prevention of admission to hospital and readmission rates, and increased capacity in Moray’s hospitals for people requiring acute care.
During the six month test, 48 patients aged between 64 and 96 were support by the Discharge to Assess team to return home to continue their recovery. All 48 recorded improved assessment scores in their gait, balance and mobility, reducing their risk of falls. 88% of patients agreed their functional performance had improved.
Supported early discharge through Discharge to Assess forms a key part of Moray’s Home First strategic shift to a more community focused model of care which places people and their families at the centre of decision making, working alongside them to understand what is important to them and what will enhance their personal outcomes.
Approaches are being stepped up to provide greater community support to people to maximise their ability to live independently at home and to avoid unnecessary hospital attendance or admission.