Remote monitoring to support rapid assessment of vulnerable care home residents

Case study: Adam Remmer, Charge Nurse, South Tyneside and Sunderland NHS Foundation Trust.

Background of change and intervention

Before the pandemic, services in South Tyneside and Sunderland were already adopting digital technology to improve the monitoring of care home residents across the area. During the pandemic, the potential of these digital solutions to empower care home staff to spot the early signs of deterioration and communicate observations across organisations has been widely acknowledged. This case study explores how adoption of these approaches has been further cemented in Sunderland.

Learning and advice to be shared

The local deployment of remote monitoring technology has been integrated within clinical practice.  In particular, it has been aligned with tools such as the National Early Warning Signs score to detect and respond to clinical deterioration and “Is my resident unwell?”, a checklist which helps care home staff to pass on concerns to other healthcare professionals.

The kit involved allows care home staff to measure vital signs, take photos as well as recording these important assessments/questionnaires that support communications between professionals.

The focus on avoiding unnecessary face-to face contact during the pandemic enabled an acceleration of the ability to embed the routine use of this technology. In a period of three weeks at the start of the pandemic, training was rapidly rolled-out to around a dozen additional care homes. This push ensured that training on the use of monitoring equipment had been provided to all the care homes across Sunderland.

One of the specific successes has been the way that technology has supported robust communication between care home nurses/other staff and hospital clinicians. The inclusion of structured tools and questionnaires helps avoid any important information being omitted and these assessments are supplemented by evidence through the recording of observations/clinical data. This, especially, empowers care home staff to swiftly and confidently report potential decline to ensure high quality care and better patient outcomes.

The acceleration of adoption of this digital approach during the pandemic is marked. Prior to the national lockdown 1,800 to National Early Warning Scores were being recorded locally every month. This has now increased to 2,200 NEWS scores every month.

Would it be beneficial to retain these changes?

The case for technology-enabled care is clear and existing evaluations were already showing the potential to help avoid non-elective admissions, lower A&E attendance and improve patient outcomes and satisfaction.

The pandemic has prompted the exploration of additional features within the existing technology. The sharing of images and virtual contact, for example, has reassured and helped to keep care home residents and staff safer by reducing visits. This capability is widely recognised across clinical teams to have ‘opened up a whole new world’. Going forward colleagues in the trust want to examine how the technology might be utilised as a referral platform.

The vital role of technology in the pandemic has further embedded new ways of working, enhanced the connection between care homes and hospitals and supported colleagues to help deliver improved outcomes for the elderly population.

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