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Today is the 7 year anniversary of my starting a new job with @MidlothianHSCP to help develop their “Frailty” services.
The gestation took a few months as we recruited team members and set up, but later in 2014, the Hospital at Home service was born!
The gestation took a few months as we recruited team members and set up, but later in 2014, the Hospital at Home service was born!
Huge thanks to @GrahamEllis247 for the inspiration and leading the way in Scotland. It’s amazing how far the Hospital at Home services have come, and Lanarkshire continues to lead the way on many fronts!
We were naive at the start. We wanted to recruit people with community AND hospital experience. But with most people diverging at an early point in their careers (whatever discipline they were), those folk didn’t yet exist.
So we took on team members from a range of backgrounds.
So we took on team members from a range of backgrounds.
Our two senior nurses, with us since the beginning, came from different backgrounds. One from a community role, originally in Birmingham, and the other a ward charge nurse from Edinburgh. A great skill mix!
Raising a cup of tea to you guys this morning @sharondem & @molo91!
Raising a cup of tea to you guys this morning @sharondem & @molo91!
More nurses followed and we also had the skills of the well established Rapid Response Team to draw on.
A steep learning curve for me, as a hospital doctor, working out what could and couldn’t be managed at home.
The OTs and Physios took me out with them. They taught me a lot.
A steep learning curve for me, as a hospital doctor, working out what could and couldn’t be managed at home.
The OTs and Physios took me out with them. They taught me a lot.
Although I think I was already reasonably holistic, I learned a lot about problem solving and thinking in terms of:
“What was the issue that provoked the crisis today?”
Let’s solve that first.
We can then look at all the other issues on the list later on.
“What was the issue that provoked the crisis today?”
Let’s solve that first.
We can then look at all the other issues on the list later on.
The carers taught me a lot too. The @midgov Rapid Response carers had a lot of experience & were happy to teach the “new girl” a few things.
Do you know how to get someone off the floor if they’ve fallen? Or how to assess whether they’re safe to stay at home? These guys do!
Do you know how to get someone off the floor if they’ve fallen? Or how to assess whether they’re safe to stay at home? These guys do!
Another early lesson was not to overwhelm people with care. If you’ve never had strangers in your house before, suddenly having a “four times a day care package” can be very intrusive.
Let’s go back to thinking about what’s needed immediately to deal with the crisis. Then adapt.
Let’s go back to thinking about what’s needed immediately to deal with the crisis. Then adapt.
I loved the flexibility of the Rapid Response Team. Although we all have our own roles, we can do some of each other’s too.
In hospital I didn’t have to adjust seat heights or walking frames. In my new job I also learned how to fit a commode into the back of my car!
In hospital I didn’t have to adjust seat heights or walking frames. In my new job I also learned how to fit a commode into the back of my car!
Though when I reported back to my new boss that my day’s work had included feeding a patient’s cat and making someone else a cup of tea, he chided me with:
“We’re not paying your salary for you to do those things!”
But those things kept two older people at home...
“We’re not paying your salary for you to do those things!”
But those things kept two older people at home...
We’ve grown as a team and developed new links too. We have great colleagues in the Community Respiratory Team too that we work with and also the @MidD2A Discharge to Assess team.
There’s a lot of “local” knowledge in the team too. If one person isn’t sure, they’ll ask another.
There’s a lot of “local” knowledge in the team too. If one person isn’t sure, they’ll ask another.
My work “partner” is GP trained and I’m a geriatrician. Between us that covers quite a wide spectrum of medical problems.
For the last four years, we’ve had GP trainees on the team too. We get to know them quite well, chatting in the car on our way to see people.
I like this.
For the last four years, we’ve had GP trainees on the team too. We get to know them quite well, chatting in the car on our way to see people.
I like this.
A big excitement last year was getting new cars for the team! Very snazzy... with “Hospital at Home” decals as well!
Much more practical than the pool cars the nurses used before. A morale boost to the team and a good way of increasing our profile as we go out on visits.
Much more practical than the pool cars the nurses used before. A morale boost to the team and a good way of increasing our profile as we go out on visits.
So many stories over 7 years.
2020 was different, and yet much the same. We never stopped seeing people, in their houses, face to face, so a lot of what happened was “business as usual”.
Though we too saw our share of tragedies in the #Covid19 pandemic.
2020 was different, and yet much the same. We never stopped seeing people, in their houses, face to face, so a lot of what happened was “business as usual”.
Though we too saw our share of tragedies in the #Covid19 pandemic.
So here’s to 2021!
We have lots of ideas of what we’d like to do & how we’d like to help more people to stay out of the “big shiny hospital” in the months to come.
Thank you to all my Twitter friends for following our Hospital at Home stories & helping spread the word!
Cheers!
We have lots of ideas of what we’d like to do & how we’d like to help more people to stay out of the “big shiny hospital” in the months to come.
Thank you to all my Twitter friends for following our Hospital at Home stories & helping spread the word!
Cheers!
