降低老年养老院居民的住院率：养老院创新计划（CHIP）的 4 年评估。

Reducing hospital admissions in older care home residents: a 4-year evaluation of the care home innovation Programme (CHIP).

机构信息

Institute of Population Health Sciences, University of Liverpool, Waterhouse Building B Block, Brownlow Street, Liverpool, L69 3GL, England.

NIHR ARC NWC, Liverpool, England.

出版信息

BMC Health Serv Res. 2020 Feb 6;20(1):94. doi: 10.1186/s12913-020-4945-9.

BACKGROUND

Older care home residents frequently attend emergency departments with a high conversion to admissions. For this purpose, a novel Care Home Innovation Programme (CHIP) was introduced with the aim of reducing potentially avoidable hospital admissions by 30%. The aim of this study is to evaluate the implementation of this innovative service in practice.

METHODS

A total of 32 care homes with 1314 beds in South Sefton, Merseyside were invited to sign up to CHIP which was launched in April 2015 and continued in its entirety until June 2018. As part of the CHIP, care home matrons were introduced, new protocols were developed to address common presentations, a 24-h 7-day a week televideo system installed across all homes, and a quarterly training collaborative brought care homes together to learn and share good practices together. Data on emergency calls and calls resulting in conveyances were recorded over a four-year period, and analysed using frequency analysis.

RESULTS

In comparison to the 12 months prior to launch, over a four-year period, implementation of the CHIP resulted in a 15% reduction of emergency calls, and in a 19% reduction of conveyances to hospital.

CONCLUSIONS

The South Sefton CHIP demonstrated itself an effective programme in reducing conveyances and consequently, hospital admissions of care home residents. This model will be superseded by the enhanced health in care homes being promoted by the NHS Long Term Care Plan.

背景

老年疗养院的居民经常因高转化率而前往急诊部门。为此，引入了一项新的疗养院创新计划（CHIP），旨在将潜在可避免的住院人数减少 30%。本研究的目的是评估该创新服务在实践中的实施情况。

方法

共有 32 家拥有 1314 张床位的疗养院被邀请参加 CHIP，该计划于 2015 年 4 月启动，并持续到 2018 年 6 月。作为 CHIP 的一部分，引入了疗养院护士长，制定了新的协议来解决常见的表现，在所有疗养院都安装了 24 小时 7 天每周的电视视频系统，并举办了季度培训合作，让疗养院聚集在一起学习和分享良好实践。在四年的时间里，记录了紧急呼叫和导致转运的呼叫的数据，并使用频率分析进行了分析。