A rapid review of what innovative workforce models have helped to rapidly grow capacity for community care to help older adults leave hospital

What innovative workforce models have helped to rapidly grow capacity for community care to help older adults leave hospital?

Overview

A rapid review of existing evidence was carried out by the research team at the Specialist Unit for Review Evidence (SURE, Cardiff University) and the Wales COVID-19 Evidence Centre (WCEC). This review was requested by Social Care Wales and Health Education and Improvement Wales (HEIW).

Context          

Older adults who have been in hospital and are now medically fit for ‘discharge’ may need extra care to return and settle at home. Long hospital stays can be risky for older adults as there’s a greater chance of catching hospital infection. Patients may also find it difficult to return to managing alone at home. Delays in discharge are bad for the individual patient and the hospital / NHS as a whole, as other patients cannot then be admitted when needed.

Aim

The aim of this study was to see if there are existing methods to help to grow capacity quickly, for better ‘community care’ when older adults leave hospital.

Methods

The research team reviewed 19 studies, which evaluated five different potential areas of improvement.

Findings

The researchers concluded that there is not currently enough good quality evidence to provide a clear answer to the main research question.

Interventions that showed the most promise were ‘early supported discharge’ and ‘ensuring continuity of care during the discharge period’.

The evidence suggests that the more support an older adult receives in moving home from hospital, the better the outcomes. Further research would help to identify the best approach to minimising delays in discharge.

Focus on the patient as an individual also appears to be very important in successful transitions. This impacts staffing and must be cost-effective so will require the support of local health boards, local authorities and the voluntary sector. The extra work required by social services and the health service must be well planned.

Conclusion 

No single method has yet been proven to ensure the best outcomes for patients. Further research and investment in this area is needed.

This review highlights the need for a standardised method which helps support the best possible care for older adults leaving hospital.

This will require commitment from all involved, including Welsh Government, local authorities and the voluntary sector to help us prepare for any potential future pandemics.

Read the full report or view the infographic

Summary author: Robert Hall, Patient and Public Group representative