Early discharge option for older patients

Older patients at Dunedin Hospital are likely to be offered an early discharge from next week.

A two-year pilot scheme in four wards and the emergency department for patients aged over 65 will be extended to the rest of the hospital on Monday.

Clinical nurse specialist Eileen Richardson said benefits of heading home early included more independence, less anxiety, less risk of losing muscle condition, and avoiding a slight increased risk of a hospital-acquired infection.

''With older people the familiarity of their usual environment is quite often key in aiding their recovery,'' she said.

The early discharge rehabilitation service (EDRS) was optional for patients.

''It's not about identifying patients to push them out of hospital earlier. It's about offering a different care option for patients,'' Mrs Richardson said.

To prepare for the introduction, service staff were doubled, and hours were extended to include Saturdays and longer weekdays.

The pilot handled just a handful of patients a week, and it was too soon to know how many patients would be involved from next week.

''I don't expect an enormous rush at first. It does actually take a little bit of a culture change, and a mind change as well, to consider patients that might be able to go home with the additional support that wasn't there before.''

How early they were discharged depended on the case. If eligible for inpatient rehabilitation, patients could opt to go home as much as a fortnight early. For others, it might be up to four days early.

An evaluation of the pilot found acute readmission rates were no worse for those on the early discharge programme. Patients could receive hospital-provided food in their first day or two at home, if required. If food production moved to Christchurch, as was proposed, a petty cash fund or something similar would be needed for this.

The team, part of Older People's Health, included physiotherapy, occupational therapy, nursing, rehabilitation assistants, a doctor and an administrator.

EDRS acting unit manager Helen Murphy said the service was unlikely to save much money, because of the increased resources required in the community.

If successful, the programme could be extended to other age groups.

- eileen.goodwin@odt.co.nz

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