Innovative NEWS from home

Julian Emmanuel

doi:10.7861/clinmedicine.17-3-s21

Aims

Share an innovative approach to acute care at home utilising National Early Warning Score (NEWS) as a track-and-trigger mechanism.

Methods

We have cared for 2,400 patients in an acute hospital-at-home model of care. Patients are transferred home from the emergency department or acute ward and under the hospital-at-home team. The team consists of a consultant, specialty registrar, nurse in charge and pharmacist in hospital, with several nurses and healthcare assistants delivering care in the community. Monitoring equipment is placed at the patient’s home. The nurse attending the patient at home calculates NEWS on a tablet. The doctors at the base hospital are available 24 hours a day to review patients. All patient records are held electronically. All NEWS data are also held electronically.

Results

The length-of-stay (LOS) analysis on 610 patients from the top 10 Healthcare Resource Group (HRG)-coded admissions was 6.66±2.10 days. This compared favourably with the acute trust’s 6.88±2.18 days, for the same conditions. The number of patients transferred back on 2,249 discharges was 206 (9.16%). NEWS track-and-trigger data on 42 patients: admission NEWS = 2.07±0.32, and discharge NEWS = 0.57±0.09.

Conclusions

The comparative LOS analysis points to an efficient service. The transfer-back ratio points to a safe service. The NEWS analysis highlights the importance of change in NEWS and away from absolute numbers. We have developed an effective and efficient acute hospital-at-home service utilising innovative solutions.

Conflict of interest statement

There is no conflict of interest. ORLA Healthcare is an independent provider of acute care-at-home services. ORLA Healthcare works in partnership with NHS providers.