A nurse-led telehealth project for patients with COPD has helped to slash the number of unnecessary hospital admissions at an acute trust in Leicestershire.
Nurses at University Hospitals of Leicester NHS Trust, conducted a 12-month pilot of the system – known as doc@HOME and funded by Leicester County Council, to assess whether it could help patients with COPD self-manage their condition.
Between April 2008 and April 2009, 40 patients had the handheld monitoring “hubs” installed in their homes to record basic nursing observations and individual patient data.
The patients answered a series of questions about their physical, social and emotional well being twice a day, which were then transmitted to a triage nurse via a secure server. Patients also recorded their observations, such as pulse oximetry and blood pressure, and entered the data into the device.
Using a “traffic light” system, the triage nurse categorised patients according to their needs, with green meaning no intervention required, amber highlighting that patients required a phone call, and red indicating urgent problems.
The patient’s record was then accessed by a community matron who used the information to send a message directly to the patient asking them to visit their GP surgery, for example, or to change the frequency and/or volume of their medication.
During the 12-month pilot, 58 hospital admissions in 43 patients were recorded. However, the nurses also recorded 202 patient interventions, such as a visit from a community matron, instigation by the triage nurse to start steroids or antibiotics, or advising the patient to see their GP.
These interventions saved around 144 unnecessary hospital admissions, potentially saving the trust around £259,000 over the course of a year.
The pilot study also revealed that six months prior to the implementation of the system, 38 hospital admissions among 16 COPD patients were recorded.
But after these 16 patients started using the home hubs, the number of hospital admissions fell to just five hospital admissions over the following six months, potentially saving the trust more than £46,000.
University Hospitals of Leicester Trust consultant nurse in respiratory medicine Jane Scullion said: “Patients with COPD want to stay in their homes, but they also want support from somebody who understands their condition and can give them advice and reassurance.
“We have to look at different ways of working, and this system fits very well with the government’s long term conditions agenda of keeping care closer to home,” she added.
However, Ms Scullion also told Nursing Times that because the pilot has finished there are 40 hubs going unused, and patients who had previously been kept out of hospital with this method are starting to be readmitted.