Reduced readmission rates

Bose with care home resident and document

Patient readmission rates to King's College Hospital NHS Foundation Trust from care homes have reduced during a recent project in Southwark and Lambeth.

Evidence suggests that a transfer of care bundle tested over six months helped reduce the readmissions rate across the two boroughs by 16 per cent. The rate from care homes to King's College Hospital was 22 per cent and reduced to 6 per cent. The test was undertaken with a group of 53 patients who were discharged from the trust, from June to December.

The transfer of care bundle is a group of documents which sets out the best practice steps of discharging a patient to care homes and transferred to hospital. The bundle, which was designed by local hospital and care home staff, contains a discharge checklist and the necessary transfer of care forms.

Care home residents tend to be some of the frailest people in Southwark and Lambeth. The patients’ experience of the transfer of care process has a huge impact on these people and whether they are readmitted to hospital, therefore it is important it is done successfully.

During the test relationships and communication between care home and hospital staff improved. They felt more confident contacting each other when they needed to.

Nicky Hayes, Consultant Nurse for Older People, King's College Hospital NHS Foundation Trust: “Communication between hospital and care home staff improves when the discharge bundle is used. This means that we can quickly tackle any patient care issues together with our care home colleagues.”

King’s College Hospital NHS Foundation Trust and all care homes in Southwark and Lambeth took part in the project, as part of Southwark and Lambeth Integrated Care.