57 * GERIATRICIAN INPUT INTO 12 CARE HOMES REDUCED EMERGENCY HOSPITAL ADMISSIONS WHICH WAS MAINTAINED WITH EDUCATION & TRAINING OF GPS AND CARE HOME STAFF

Abstract

Background: The Nursing Home Project (Lisk et al, poster BGS spring 2011) was started in April 2010 with 3 nursing homes following an audit which showed which showed 1247 admissions from care homes in 2008-09. Due to its success, the project was expanded to 12 nursing homes from April 2011 – Oct 2012.Innovation: Four interventions were carried out to reduce hospital admissions.• Monthly Medical Advisory Meetings with GPs by a Consultant Geriatrician.• Available for telephone advice on a daily basis.• Medihome – A healthcare company that can provide intravenous antibiotics and fluids in nursing homes.• End of Life Care discussions with advance care planning During the period April 2011- Oct 2012, we agreed only 1 GP per care home. This allowed for education and training of the GP and care home staff.From Oct 2012, the GPs took the lead role in carrying out the above interventions with telephone advice as necessary from geriatricians.Evaluation: There were 432 admissions from these 12 nursing homes prior to the start of the project (April 2009-March 2010). During the intervention (April 2011-March 2012), admissions were reduced to 282 (35% reduction) with potential savings of £369,750. 1This reduction has been maintained (April 2012 – March 2013) this financial year as only 303 residents admitted despite the GPs taking the lead from Oct 2012.Overall trend in rising admissions from care homes were also reversed despite covering only 12 out of 60 care homes.Conclusion: The results show that geriatrician input into nursing homes had a significant impact on admissions. It is important that initiatives such as this, which focus on partnership working across primary and secondary care interface, are adopted more widely to enable older patients to be treated in the most appropriate environment for their social and medical needs.1. Non-elective in-patient stays (long stays) £2465 - PSSRU data