DIR Return Create A Forum - Home
---------------------------------------------------------
Commissioning Forum
HTML https://commissioningforum.createaforum.com
---------------------------------------------------------
*****************************************************
DIR Return to: Non Elective Admission Reduction
*****************************************************
#Post#: 23--------------------------------------------------
Alcohol Care team replication
By: admini5 Date: April 16, 2015, 5:15 am
---------------------------------------------------------
If Alcohol Care Team Services has been replicated how
frequently/widely has it been replicated?
Different elements of an alcohol team approach have been
introduced in different places.
Alcohol Specialist Nurse Service in Nottingham
Implementation of an Alcohol Specialist Nurse Service in
Nottingham improved the health outcomes and quality of care of
patients admitted to hospital for detoxification, and also of
those admitted for the complications of alcohol-related
cirrhosis (Ryder et al. 2010).
Hospital admissions were reduced by two-thirds, resulting in a
saving of 36.4 bed days per month in patients admitted for
detoxification. Clinical incidents were reduced by 75%. Liver
enzyme abnormalities were halved and there was also a reduction
in bed days used in the cirrhotic group from 6.3 to 3.2 days per
month.
St Mary’s Hospital London
St Mary’s Hospital, London has engaged and trained staff to give
brief intervention, education, audit and feedback to patients
presenting to A&E (Touquet and Brown 2009).
They have designed the 1-minute Paddington Alcohol Test to
identify patients with an alcohol-related problem. This resulted
in a 10-fold increase in referrals to an Alcohol Health Worker
(AHW). The AHW gave brief intervention and education, which
resulted in a reduction of 43% in alcohol consumption. Every two
referrals to the AHW resulted in one fewer re-attendance during
the following year. If patients are offered an appointment with
the AHW on the same day, almost two-thirds attend. If the
appointment is delayed for longer than 48 hours, only 28%
attend. Hence, the intervention needs to be immediate.
Salford Royal NHS Foundation Trust
Salford Royal NHS Foundation Trust has established a
hospital-led AOAS. The team works with a cohort of the top 30
patients (frequent attenders), with the highest levels of
alcohol-related admissions over a 6 month period. Each 6 months,
this cohort is refreshed. The team also works proactively with
any patient, who has had two alcohol-related admissions within a
short period of time, the so-called “fast risers”.
Work with the first top 30 cohort resulted in a 66% reduction in
Emergency Department attendances in the 3 month period
post-intervention, when compared to the 3 month period prior to
intervention( average monthly attendances were reduced from 83
to 28). There was also a 63% reduction in hospital admissions
(35 to 13). This reduction in admissions is being maintained,
even though the team is now working with the next top 30 cohort
The Royal Liverpool Hospital
The Royal Liverpool Hospital has introduced an extension of the
role of alcohol specialist nurses from A&E to inpatient care,
preventing 150 admissions per year. The roles of alcohol
specialist nurses in Liverpool have since been further developed
into a Nurse-led Alcohol Services Lifestyle Team, with daily
clinics in different locations in the city. They provide access
for GPs to refer patients to the service (see the DH Alcohol
Learning Centre
HTML http://www.alcohollearningcentre.org.uk/LocalInitiatives/
for
more details).
*****************************************************