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Discharge with integrated Care Support - Part 2

Posted By Big Toe

"Discharge with integrated Care Support - Part 2"

About: North Lanarkshire Council University Hospital Monklands University Hospital Monklands / Care of the Elderly (Wards 14,20,22)

(as a relative),

Following on from my previous post...

My elderly relative was discharged from AAU.

On the evening of her discharge, she was found to be in a chair, unable to walk unassisted, had continued to suffer from incontinence, complained about lower pelvic pain and was refusing food.

An out of hours Doctor attended, following discussion with NHS24. Upon checking my relative and review of the discharge letter; stated that this had been a 'failed discharge' and that they were requesting an ambulance to take her back to Monklands Hospital.

She passed via the emergency department and stayed in AAU......Third admission within 48 hours

Within AAU the next afternoon/evening a nurse advised her family that it was a simple UTI and then advised them that she was being discharged.

The family stated that they wished to she her walking before she could go home. They were advised that it was a simple UTI, that she was being discharged and how were they taking her home.

The family stated to the Nurse that she would have to arrange this and proceeded to walk out of AAU (upset, but quite rightly frustrated of the treatment and lack of person centred / patient care attitude toward their mother)

The nurse then proceed to run after them with the discharge letter and asked them to wait.

After a short while, they were advised that my relative was being moved to a 'care of the elderly' ward and that she was being admitted for further tests.

I presume that either the Charge Nurse or FY1 could see that after 3 failed discharges that there is an underlying issue; UTI leading to incontinence, not eating and drinking for fear of not being able to walk to her toilet, constant falling due to blood pressure? Surely she should have been tested for this on her initial admission? Simple tests and diagnostics?

I believe that she is receiving physio, but is still unable to walk herself or unaided, even with a frame.

This time it appears that there is some communication between Secondary and Primary Care, with the involvement of Social Services to assess her needs and requirements prior to discharge.

Whilst I appreciate bed capacity issues may have been the reason for previous discharges. The result has been two additional admissions, out of hours Doctor time, Ambulance time, Acute staffing time.......both money and time wasted !

As I stated previously; where is the patient centred care approach and the NHS 20:20 Vision in this instance? Is this how Monklands routinely process dementia related patients?

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Responses

Response from Eileen Clarke, Senior Nurse - Surgical, University Hospital Monklands, NHS Lanarkshire 6 years ago
Eileen Clarke
Senior Nurse - Surgical, University Hospital Monklands,
NHS Lanarkshire

Submitted on 26/10/2017 at 12:40
Published on Care Opinion at 12:41

picture of Eileen Clarke

Dear Big Toe

I read with great disappointment the description of your experience at Monklands Hospital.

I understand this situation must have been very difficult for you as a family and I am very keen to speak to you to help us investigate what appears to have been a very poor set of circumstances, for which I can only apologise. It is very important for us to get this feedback as we will use it to develop care for other patients. The information you can provide will be shared and discussed in our multidisciplinary forums to prevent a similar experience from happening in the future.

Please be assured that our aim is to provide person-centred care to all patients at all times and I sincerely apologise that you feel we fell short of this.

I would really appreciate it, if you could provide me with your contact details and I can discuss this with you. If you are happy to do so, can you please contact Ann Johnston at Patient Affairs on 01236 713065 and I will be in touch.

Kind regards

Eileen

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Update posted by Big Toe (a relative)

If you refer to the original post and Part 2, this details the account of the three failed discharges and subsequent admission.

You refer to sharing this story with the multidisciplinary team. I think that ED, AAU staff and Bed Management staff should understand and reflect upon how their decision to discharge a dementia patient has a personal story and that the are not 'merely' a bed number; that individual patient care should be a priority in a caring profession.

At a time when financial savings and bed capacity issues are foremost within the NHS, the re-admissions as a result of 'failed' discharges would have impacted upon staffing resource, time and costs.

'The standard you walk past, is the standard you accept'....it may be that Monklands are accepting this as standard practise and have forgotten about patient centred care?

Whilst I can understand an initial failing in the system regarding the first discharge, the further discharges would indicate an inherent fault within the discharge process & bed management.....would you agree?

Response from Lesley Mallon, Risk Management Facilitator, University Hospital Hairmyres, NHS Lanarkshire 6 years ago
Lesley Mallon
Risk Management Facilitator, University Hospital Hairmyres,
NHS Lanarkshire

Submitted on 27/10/2017 at 15:15
Published on Care Opinion at 15:51

picture of Lesley Mallon

Dear Big Toe

Thank you for providing an update to your post. As previously intimated by Eileen Clarke, she would be more than happy to discuss your experience in greater detail. Please contact Patient Affairs staff on 01236 713065 who will be more than happy to facilitate a discussion between you both.

Kind regards.

Lesley

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