The campaign is based on research led by the National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), in collaboration with lead clinicians from North Bristol and University Hospitals Birmingham NHS Trusts, which aims to understand what causes delays in discharging frail and elderly patients from hospital. These delays cost the NHS around £820 million a year and can be upsetting for patients and their families. For many older patients, the longer that they stay in hospital, the greater the risk that their strength and independence will diminish.
When planning for a patient to leave hospital safely, different pieces of information about the patient need to be brought together. If any information is missing, it can be more difficult to decide what support the patient will need, and this may delay them leaving hospital.
By examining in detail what happens on the wards of the two participating NHS Trusts, our researchers aim to improve the process of discharging frail and elderly patients from these hospitals, and in hospitals across the UK. They are now working with the health system to begin to implement the findings.
Based on their research, and working alongside public contributors, researchers have created an Information About Me video animation and a sample Information About Me form to complete and provide to hospital staff on arrival. ‘Information About Me’ encourages patients, or their relatives or carers, to collect information about the patient’s day-to-day life – where they live, how they look after themselves, and who supports or cares for them – and to make hospital staff aware of this information when patients are admitted. Recording all the relevant information in one place means that this information is more accessible to staff, and delays can be avoided.
People who are older and frail are more likely to struggle after even a minor illness or a change in medication or environment. Public contributor Sarah Biggs volunteered to be part of the study team because her late mother had endured a lengthy hospital stay following a fall.
Sarah said: “Staff need to understand what the person’s baseline was before they went into hospital. If they can walk and talk and dance and listen to music and be independent, then they need to know that. But if they can’t do any of those things, and this is how they currently function and this is the help that they get, then that needs to be understood too. With my mother, I never had the chance to set this out.” Read more about Sarah’s experience of her late mother’s hospital stay.
Dr Kyra Neubauer, Consultant Physician at North Bristol NHS Trust, said: “Although geriatricians have long recognised the importance of 'information about me’ this research confirmed that such information needs to be collected as early as possible and recorded in a way that makes it easily accessible to all staff. If patients, relatives and carers understand the value of this information, they can help hospital staff to facilitate safe, appropriate and speedier discharges for themselves or their loved ones.”
Dr Sabi Redwood, Deputy Director of NIHR ARC West and the study’s principal investigator, added: “Our study found that information about an older person’s day-to-day life was really important to help staff in hospital and in the community to make good decisions and plan for their discharge. This information is about knowing how independent an older person is, what they can do for themselves and what they need help with, who pops in to see and support them, and what is important to them.
“This vital information was often not recorded consistently or stored in a way that everyone involved in their care could see. That meant that patients and family members were often asked the same questions which can be frustrating. Having the information in one place for all involved helped the planning and co-ordinating of care.”