Hospital at Home and Point-of-care diagnostics, creating sustainability within healthcare.
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Résumé
Hospital at Home (HaH) embodies a transformative approach to healthcare delivery, facilitating early discharge and admission avoidance by offering hospital-level diagnostics and treatment within the community. This innovative approach not only expands treatment options for patients but also accelerates the goals outlined in the NHS 10-year plan, aiming to enhance the sustainability of our healthcare system. By bringing care closer to home, HaH reduces the strain on secondary care services whilst optimising outcomes, particularly for frail patients who are vulnerable to adverse effects associated with hospital admission. The Guys and St Thomas’ H@H team explored the use of point-of-care (POC) blood testing as an initiative to provide rapid diagnostics. We were keen to understand whether introducing POC diagnostics would support early discharge, enhancing patient flow as well as allowing us to optimise our capacity to admit new patients to the service and prevent admission thus reducing our carbon footprint by minimising hospital admissions and associated costs. This includes not only the direct expenses of ambulance transfers and hospital stays but also the indirect costs related to adverse effects associated with admission. In this retrospective cohort study, we evaluated 152 patients referred to H@H for urgent assessment within a 2-hour response time. The patients underwent POC diagnostics as part of their assessment, and the collected data underwent retrospective analysis. Key outcome measures were assessed, focusing on the extent to which POC diagnostics facilitated early discharge and admission avoidance through timely diagnosis and appropriate intervention. Additionally, demographic data were collected to assess the prevalence of severe frailty among the patient population. The results of our study demonstrate the significant impact of POC diagnostics on clinical outcomes and treatment interventions. We observed a notable change in clinical outcome in 67% of patients, with nearly 40% receiving earlier therapeutic interventions as a result. Analysis of demographic data revealed that a substantial portion (74%) of our cohort exhibited a clinical frailty score exceeding 6, underscoring the vulnerability of elderly individuals within our patient population. Remarkably, out of the 152 patients assessed, only nine required hospitalisation for further treatment. These findings emphasise the transformative potential of implementing POC diagnostics in managing the health of elderly individuals and optimising treatment outcomes. In conclusion, our study underscores the pivotal role of POC testing in enhancing early diagnoses and broadening the scope of therapeutic interventions for patients managed within their homes. The investment in community-based care infrastructure not only bolsters the resilience of our healthcare system but also addresses the evolving needs of the population. With a significant proportion of patients experiencing tangible improvements in clinical outcomes, our findings highlight the potential for POC testing to revolutionise care delivery, particularly for patients contending with severe frailty. Overall, our commitment to home-based care contributes to a sustainable NHS by optimising resource utilisation, enhancing patient outcomes, and fostering a patient-centred approach to healthcare delivery. This paradigm shift aligns with broader healthcare system objectives of improving efficiency, reducing costs, and elevating the overall quality of care, thereby laying the groundwork.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle