Innovation/Service Improvement Synopsis
Hospital Outpatient Treatments (HOT) clinics
An admission avoidance clinic for adult respiratory patients. It is recognised that a large number of patients with respiratory disease are admitted to hospital, where early specialist intervention may have resulted in the patient being managed at home. A daily respiratory “hot” clinic was therefore established. GP’s may refer patients who they believe to be threatening admission up to 12 midday each day and they will be seen on the same day by a respiratory consultant
Long Term Condition
Respiratory disease
Meets National Priority Areas
Admission Avoidance
Benefits to Patient
A large number of patients are reviewed by the correct specialist team in a timely manner. A larger number of patients managed in their own homes, with the assistance of resp. specialist nurses
Benefits to Staff
Has allowed senior medical staff to focus their attention on some of the most acutely unwell respiratory patients and to use available resources to maximum efficiency to prevent un-necessary admissions to hard pressed medical beds
Cost Savings/Efficiencies
Completed a three year audit of activity. During the period 2007-2009, 1,381 patients were seen in the hot clinic. Case notes of a random sample of 750 were reviewed. Mean age was 63 years. 28% of patients were seen on the day of referral and 50% the following day. Most frequent diagnosis was COPD exacerbation (26%), asthma (9%), pleural effusion (8%) and pneumonia (7%). 17% of patients were admitted directly and a further 2% within one week of being seen and a further 5% within one month. 76% of patients were managed wholly within the com-munity. Respiratory specialists judged the referral as appropriate in 92% of cases. This provides a cost saving to the primary care trust. Patients admitted for less than 48 hours attract a tariff of £846 and those admitted over 48 hours generally attract a tariff of approx. £2,200. The tariff for a hot clinic attendance is £346. The service is consistently rated highly by patients
Outcomes Measured
If patients attending the hot clinic were appropriate at the rate indicated by the consultants in the clinic, then the total number of admissions avoided over three years equate to a total saving of over £600,000 to the local healthcare economy. This saving was achieved whilst providing a high standard of care which was highly rated by service users and which provided high quality care closer to the patient’s home.
Sustainability
To ensure availability of consultant cover job plans were rewritten to ring fence 0.5 PAs daily to ensure medical staff had available time to provide adequate cover for the hot clinic. It would not be possible to conduct a clinic such as this on an ad hoc basis, due to the variable level of demand
Transferable
If patients attending the hot clinic were appropriate at the rate indicated by the consultants in the clinic, then the total number of admissions avoided over three years equate to a total saving of over £600,000 to the local healthcare economy. This saving was achieved whilst providing a high standard of care which was highly rated by service users and which provided high quality care closer to the patient’s home
Project Status
Ongoing
For further information email
info@nisw.co.uk
To download this case study please click icon.
Download