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Table 2 Data outcomes

From: Multidisciplinary residential home intervention to improve outcomes for frail residents

  Cycle 1 Cycle 2
  Care Home 1 Care Home 2 Care Home 3
Presenting complaints Stealing other residents’ food in context of dementia
Worsened cough and breathlessness
Cognitive decline and refusal of medications including warfarin
Aggression and paranoia
Breathlessness and ankle swelling
Weight loss, day time drowsiness
Uncommunicative, decline in mobility, decline in oral intake
Pain and poor mobility
Falls
Sleeping in chair, leg pain and swelling
Anxiety, agitation
Recurrent UTI, generally unwell and has been in bed for a no. of weeks
Rash, hallucinations and delusions
Weight loss
Difficulty breathing
Challenging behaviour
Swollen legs
Refusing medication
General decline possible depression
Reduced oral intake
Reduced mobility
Low mood, insomnia
Slowing and movement disorder
Falls
Depression in context of dementia
New patient needing CGA
Loose stool, anaemia
Number of GCA reviews held 9 4 21
Mean change in number of medications (range) −1.4
(−3 to + 1)
−0.3
(− 1 to 0)
−2.1
(− 18 to + 1)
Change in BPSD (staff report) 3/3 improved 1/4 improved
3/4 no different
Data not collected in this cycle
Change in BPSD (family report) 3/3 improved 2/4 improved
2/4 no different
Data not collected in this cycle
Number of reviews attended by relatives
(% of total participating residents)
1
(11.1%)
0
(0%)
1
(4.8%)
Number of residents with ACP initiated or reviewed
(% of total participating residents)
7
(77.8%)
3
(75%)
16
(76.2%)
Number of DNAR forms completed or reviewed pre- and post- MDT (% of total participating residents) 6 newly initiated
(66.7%)
2 newly initiated
(50.0%)
Pre-MDT = 4 (19%)
Post-MDT = 19 (90.5%)
Number of patients with Coordinate My Care record created (% of total participating residents) 0
(0%)
0
(0%)
8
(38.1%)
Project period (months) 7 3 10
Actual number of admissions to hospital during the project period in intervention residents (no. per month) 1 (0.16) 0 (0.0) 0 (0.0)
Number of admissions among participating residents in 12 months prior to reviews (mean per person over 12 months) Data not collected in this cycle Data not collected in this cycle 25 (1.19)
Number of admissions among participating residents in 12 months post review (mean per person over 12 months) Data not collected in this cycle Data not collected in this cycle 6 (0.29)
Reduction of admissions among participating residents over 1 year (mean per person over 12 months) Data not collected in this cycle Data not collected in this cycle 19 (0.9)
Costs of hospital admissions for the whole care home Data not collected in this cycle Data not collected in this cycle 12 months prior to intervention
£55,678
During year of intervention
£49,653
Number of educational sessions 5 2 9
Topics of half hour educational sessions Polypharmacy and medication errors
Challenging behaviour in dementia
Nutrition Pain in dementia
Difficult ACP discussions
Dementia pre-diagnosis counselling
Cardiovascular complications in geriatrics
Skin care in the older patient
Advance care planning
Nutrition and weight loss
Morbidity and mortality meeting
End of life in the care home
Old age psychiatry
Behavioural symptom management
Rationalisation of medications
Communication between primary and secondary care