QI 140 To reduce the length of stay within the Crisis Home Treatment Team (CRHT) for Older Adults

Abstract

Aim: To reduce the length of stay within the Crisis Home Treatment Team (CRHT) to 42 days for 60% of Older Adults by September 2021. The age integrated CRHT caters for people aged 18 years and over. Clinical reviews within the team indicated inadequate risk assessments leading to ineffective management plans when dealing with older adult referrals. Informal discussion with staff revealed lack of experience and confidence leading to poor service delivery and impact on length of stay with the team. Key areas of focus 1.Recruit skilled professionals within Triage and Assessment. Team with older adult experience. 2. Develop older adult champions. 3. Develop link workers within IPUs who can work alongside the champions for seamless transfer of patients. Tools Used: Plan, Do, Study, Act (PDSA) Cycle which is a framework that helps you to test small changes. This is part of the Model for Improvement framework, which helps you to test out small changes and build on the learning from each cycle - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-pdsa-cycles-model-for-improvement.pdf; Driver Diagram which is a tool designed to show 'cause and effect' and can help you plan your improvement project - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-driver-diagrams.pdf. Project Impact: Training : Feedback before and after related to confidence in dealing with older adult referrals. Overall, very positive feedback and request for more online resources related to social care and voluntary sector –which were sent to attendees. Referrals: There was a very marked reduction in the number of referrals received between the 2020 period and the 2021 period. Reduction occurred in referrals which then resulted in relatively short lengths of stay. 30.8% of the overall reduction of 318 referrals was in referrals that were discharged on the same day, and 84.3% of the reduction comes from referrals discharged within four days. The number of referrals discharged on the same day fell from 110 in 2020 to just 12 in 2021.