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Team Approach To Helping Patients At Home

Fuseworks Media
Fuseworks Media
Team Approach To Helping Patients At Home

Waikato District Health Board is to spend $1.2 million on a programme to provide and promote rehabilitation for patients 18 years and over within their home environment to keep them out of hospitals and residential care facilities.

When the Supported Transfer and Accelerated Rehabilitation Team (START) programme starts on 1 September, it will help patients to remain at home and prevent unnecessary admissions. This will also reduce pressure on beds in the DHB's hospitals by looking at earlier discharge methods and a rapid response to patients who present at emergency departments.

Nurses from the Older Persons and Rehabilitation Services, outpatient and assessment team, ran a pilot project in Waikato Hospital's emergency department last year and found some of the elderly patient admissions to the hospital were for social rather than medical reasons.

Such admissions put pressure on already stretched hospital beds and can result in the cancellation of elective surgeries. Elective surgery is for planned non-emergency procedures which allow the patient and doctor to determine the best time and place for it. Cancellations cause major disruptions and inconvenience for all concerned.

In some cases the elderly patients remained under observation for more than six hours in the emergency department. One of the Minister of Health's health targets is that patients should be seen, treated and discharged within six hours from emergency departments.

Older Persons and Rehabilitation Services group manager Barbara Garbutt said START would provide up to six weeks of intensive interdisciplinary home rehabilitation for adults 18 years and over who meet entry criteria following their discharge from Waikato or Thames hospitals.

Patients include the elderly, stroke and rehabilitation clients.

"We want to provide increased support for people at home and prevent avoidable hospital admissions from our emergency departments and free up hospital beds by providing a responsive assessment and home support service," said Mrs Garbutt.

START provides appropriate seven-day support for up to six weeks. The intention is to roll it out across the whole district health board in time.

The therapy involves a number of medical, allied health and community professionals and includes:

Health care assistants


Occupational therapists

Registered nurses

Social workers

Appropriate cultural assistance.

The START programme is similar to a model used at St Thomas' Hospital in London. Waikato would be the first DHB to run the project in New Zealand. The UK model has been adapted and fine-tuned for the NZ environment.

"Continuity of care between hospital and the community is important and we believe this investment in preventive and rehabilitation services will go a long way to freeing up hospital beds for those who really need them," said Mrs Garbutt.

From 13 August, no new referrals have been taken into the home hospital. Patients will be cared for in Waikato Hospital's refurbished ward 58.

Older Persons and Rehabilitation Services runs out of three wards in the hospital: ward 54, primarily for orthopaedic patients, ward 55 for stroke and stroke rehabilitation patients and ward 58 providing rehabilitation and geriatric care.

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