Four core terms to master Out-of-date terminology Correct terminology (NHS) Enhanced services Extended primary care services Community services Services delivered outside of hospital Shared care Services delivered by primary care in partnership with hospital Step-down care
Community monitoring or Primary care-based management
The tool identifies patients who will require admission to the AT&R service after acute care, or who are at risk of needing step-down care
. It calculates an overall score for each patient, based on their current actual (not premorbid) scores across six risk criteria: family support, mobility, cognition, continence, vision and malnutrition.
Maldonado said dexmedetomidine costs about $10 per patient more than propofol, but noted that it saves a tremendous amount of money in unused hospital days and step-down care
associated with delirium.
"However, emphasis will also be given to the promotion of independent living and intermediate step-down care
by developing more short-stay accommodation, increased day-care provision and specialist day, night and respite care for elderly people with mental health problems."
Admittedly, this type of step-down care
is very different from the custodial care typically provided in assisted living, yet expanding services makes business sense, as residents age in place.
"Nursing homes have specialist care teams that can support hospitals in providing the step-down care
that will be essential to alleviate pressures.
The next steps for the sector is the publication of a national model for step-down care
services, Mr Whittington added.
Mr Humphries said there was an 'urgent need' to develop intermediate or step-down care
in the community for people coming out of hospital.
Health services in Coventry and Warwickshire have already worked on schemes to provide step-down care
for elderly people leaving hospital, linking with social services, district nursing teams and nursing homes.
The work has been commonly referred to as "step-down care
," but Mr Whittington prefers the term primary care-based management.