Reducing hospital admissions in older care home residents: a 4-year evaluation of the care home innovation Programme (CHIP).

BACKGROUND: Older care home residents frequently attend emergency departments with a high conversion to admissions. For this purpose, a novel Care Home Innovation Programme (CHIP) was introduced with the aim of reducing potentially avoidable hospital admissions by 30%. The aim of this study is to evaluate the implementation of this innovative service in practice. METHODS: A total of 32 care homes with 1314 beds in South Sefton, Merseyside were invited to sign up to CHIP which was launched in April 2015 and continued in its entirety until June 2018. As part of the CHIP, care home matrons were introduced, new protocols were developed to address common presentations, a 24-h 7-day a week televideo system installed across all homes, and a quarterly training collaborative brought care homes together to learn and share good practices together. Data on emergency calls and calls resulting in conveyances were recorded over a four-year period, and analysed using frequency analysis. RESULTS: In comparison to the 12 months prior to launch, over a four-year period, implementation of the CHIP resulted in a 15% reduction of emergency calls, and in a 19% reduction of conveyances to hospital. CONCLUSIONS: The South Sefton CHIP demonstrated itself an effective programme in reducing conveyances and consequently, hospital admissions of care home residents. This model will be superseded by the enhanced health in care homes being promoted by the NHS Long Term Care Plan.

Improving the Quality of Care in Care Homes Using the Quality Improvement Collaborative Approach: Lessons Learnt from Six Projects Conducted in the UK and The Netherlands.

The Breakthrough Series Quality Improvement Collaborative (QIC) initiative is a well-developed and widely used approach, but most of what we know about it has come from healthcare settings. In this article, those leading QICs to improve care in care homes provide detailed accounts of six QICs and share their learning of applying the QIC approach in the care home sector. Overall, five care home-specific lessons were learnt: (i) plan for the resources needed to support collaborative teams with collecting, processing, and interpreting data; (ii) create encouraging and safe working environments to help collaborative team members feel valued; (iii) recruit collaborative teams, QIC leads, and facilitators who have established relationships with care homes; (iv) regularly check project ideas are aligned with team members' job roles, responsibilities, and priorities; and (v) work flexibly and accept that planned activities may need adapting as the project progresses. These insights are targeted at teams delivering QICs in care homes. These insights demonstrate the need to consider the care home context when applying improvement tools and techniques in this setting.