Response team keeps elderly out of hospital

It's working. A Good Health Wanganui team in the community is keeping high-needs elderly people well enough to stay out of hospital and improving their quality of life.
The success of the Primary Response Team (PRT) was encouraging, members of Whanganui District Health Board committees said, because it was a first step in the direction of the board's health services redesign ? and a sign that the direction is the right one.
The manager of the board's medical, rehabilitation, community and rural services, Louise Oskam, outlined the results of the PRT team's work. She said a service allowing intravenous treatment outside hospital was well established and progress toward a Hospital in the Home initiative continued.
It was better for people to be in their own homes if possible, she said.
"People sleep better at home. Being in hospital isn't particularly good for your health, especially if you are old and frail."
An estimated 25 percent of hospital use was by people who were admitted more than three times a year, many of them elderly. In the past 12 months 20 people were admitted more than seven times.
The PRT team worked to put services in place for people with high health needs, services to keep them comfortable at home. One aspect was providing help for fragile elderly people who were discharged from hospital early ? a home visit by a district nurse on the same day, for example. Patients assured of visits before they left hospital had their fears allayed. Mrs Oskam said another 2.7 district nurses would be needed to keep service levels up, and also more training for district nurses.
The overall result of the team's work was fewer people with multiple admissions to hospital, fewer people coming to the Emergency Department and fewer day admissions.
She calculated there had been virtual cost savings for the board of $600,000. More than that, during the past four months no non-urgent surgery had had to be cancelled because beds needed by surgical patients were occupied by people with medical conditions ? a problem referred to as "bed blocking" by hospital managers. Wanganui was one of a tiny number of New Zealand hospitals that was free of this, she said.
Committee member Clive Solomon said the team's work was worthwhile just to keep those beds free, even if it didn't also save money.
Committee chair Ormond Stock congratulated Mrs Oskam for her "contagious enthusiasm". Mr Solomon said a positive attitude among staff would do more to recruit new workers than any amount of advertising.
Later, the chair of another board committee, Diana Valentine, speculated that the PRT could be based at Whanganui Accident and Medical Clinic when it moved to the hospital. Another manager said it would be at the core of specialised services for the elderly.
"It could be based anywhere? There's no worry about who provides it."