Staff from Walsall Together’s Integrated Assessment Hub are celebrating after winning the People’s Choice Award, for their poster presentation ‘Integrated Front Door,’ at Walsall Healthcare NHS Trust’s The Quality Improvement (QI) Awards.
The awards are an opportunity for all staff at Walsall Healthcare NHS Trust to showcase how their work has improved quality and delivered better value care.
The Integrated Assessment Hub first opened in December 2020 and since then has expanded to a seven days service from 8am-6pm.
It acts as a ‘front door’ providing an alternative to A&E for patients who arrive but can be cared for within the community. It is staffed by multi-disciplinary teams (MDTs) including community nurses, pharmacists, urgent care, ambulance and other community-based services as well as social care workers making it one of the first fully integrated assessment hubs of its kind in the country.
So far the team has managed to avoided 325 hospital admissions, supported 406 early discharges and referred 63 patients onto community services.
Kirsty Donaldson, Community Lead Nurse, said: “We were absolutely delighted to win the people’s choice for our poster presentation. We are so proud of the work we have done and the difference it makes for our patients in enabling them to get the care their need at home or as close to home as possible. This obviously also has a positive impact on the Trust by reducing the pressures on A&E and hospital admissions.
Patients referred onto community services are seen after being discharged, for a clinical review by a Rapid Response Nurse, to ensure they have all the support and any long term care plans in place they need to prevent re-admission.
In a recent example a 34 year old lady attended A&E with covid-19 symptoms of breathlessness and fatigue. She came with her two children, an 11 month old and a four year old, as her husband was away and not due home until the middle of August. The team placed the lady on the Safe at Home Pathway enabling community nurses to care for her at home with antibiotics. In addition to this they also ensured she was supported with food parcels and child care while she recovered.
Following a rise in referrals to the Safe at Home Pathway the team have provided further support and training across the hospital in filling out the referral forms, completed community awareness sessions with the medics and will be offering this shortly to all wards and departments, rolled out a community directory folder to all ward areas and speciality departments with information in on the support we can offer and how to refer.
The team have also been working closely with the Quality Team and are currently supporting with frailty and falls improvements including the development of a frailty poster that will guide professionals on what services to refer to in order to support patients with frailty at home.
Plans are now in place to work with the Intermediate Care Service to support earlier discharge planning, provide ward based education and community awareness and also welcome a palliative care doctor to the team two days a week to support palliative care patients attending A&E.
Daren Fradgley, Director of Integration Walsall Together, said: “A huge well done to Kirsty Donaldson, Kerry Sansara and Linda Roberts for their submission demonstrating all of the hard work and achievements of the Integrated Assessment Hub team. This is an excellent example of how co-ordinated and joined up services really do enable us to care for people where they want to be cared for and improve outcomes for the people of Walsall.”
