Discharge to recovery
Longer stays in hospital can often have a negative impact on a patient’s health. They can quickly lose mobility, the ability to do everyday tasks and frequently suffer from anxiety and other mental health issues as a result. Keeping people in hospital longer than necessary also places a huge financial and operational burden on the Acute Trusts.
Our ‘Discharge to Recovery’ service identifies and addresses the negative impact a longer than necessary stay in hospital has on the patient and benefits the Acute Trust by increasing acute bed capacity.
Hiltons unique recovery programme features a discharge lead based in the hospital and a dedicated nurse led team to support our Hilton patients on their return home. The discharge lead acts as the ‘patients champion’ throughout the patients Hilton journey to recovery.
Our home-based support is provided by Hilton Partners Personal Nursing Assistants (PNAs), working in teams to provide both emotional and physical wellbeing in recovery. This means that the physical needs of patients can be dealt with on each call, but crucially that the social element of the call is not lost, and that adequate time to monitor emotional wellbeing is taken. All data, including patient assessments, risk assessments, visit notes and feedback forms, are recorded electronically, to provide real time information on all activity.
Our service differs from the traditional model of social care in several key ways. Staff are extensively trained in methods such as health screening, which includes vital sign monitoring. The service uses an enablement model which focuses on what the patients can, or could do, rather than what they cannot do. Reconnecting to existing social networks is an important element of this, as is signposting to external agencies.
Our service has resulted in a reduction the demand for social services. We continually gather data to assess our success in reducing hospital re-admissions and reducing social service requirements