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Deconditioning Campaign

National Deconditioning
Awareness and Prevention Campaign:
Sit Up, Get Dressed, Keep Moving
Dr Amit Arora
ANP Amanda Futers
Cliff Hathaway, (Older Peoples’ Engagement Network)
HSJ awards presentation
4th October 2017

Frail Older People
Fastest growing cohort attending ED

In my early days a s a consultant I used to think about why ……
In time it became clearer when patients went into the deeper bed bases, they get deconditioned and then we took more time in rectifying the damage due to inactivity caused whilst in hospitals.
Why not address these issues on arrival….

 

The Ambition

  • Transformation of Older Peoples’ Services (TOPS).
  • Learnt from past experiences/service redesigns.
  • Safer, Faster, Better- NHS Improvement.
  • Evidence based – BGS, NICE, AFN.
  • Patient safety is paramount.
  • Cost-efficient.
  • Engagement and Involvement of staff and users.
  • Where there is a will, there is a way

 

Involvement

  • Staff Awards
  • Feedback forums
  • Weekly education sessions
  • Everyone counts
  • Open door policy and open honest communication
  • Staff development
  • Service user and staff development involved in every theme
  • Local and National bodies- from ward to board and beyond (NHSE comms, BGS comms, NHSI comms etc.)

It is a sad fact that awareness around deconditioning is poor and that MDT working to prevent this phenomenon is not always heeded.
By preventing or limiting Decon could be the difference between someone going home or into a care home
None of us wants a repeat of the Andrews story or the Mathews story because we could not place the right person at the right place at the right time. We want to get it right first time.

Bradwell tele MDT project led to 23% reduction on AE attendances and 29% reduced admissions- led to NHSE sponsored visit to VA and now piloting skype consultations in GP surgeries and care homes with CCG
CGA and medication optimization with geriatricians in primary care- published BMJ online Sept 2017
Working with local charity like Beat the Cold: reducing admissions to hospitals and promoting better health for older people in cold homes- raised money and encouraging social enterprise
Frailty school: WMAHSN patient safety collaborative has agreed to support this and they are known to promote adoption and dissemination of proven innovation.
Keele Frailty course- Sharing leadership and making champions of the future
Working with ECIP leading change for improvement in other health economies bringing in clinical perspective and acting as clinical change leader

Return on investment always a key indicator with success but quite simply we had none provided and worked within the existing workforce and financial envelope by reconfiguration of resources, improving morale, giving staff the ownership and leadership of change. They felt proud of the job they did, it made them feel better and things now happen automatically, they are no more dependent on me and I trust they will deliver.