HOMEWARD
Home or hospital for people with dementia and one or more other
multimorbidities: what is the potential to reduce avoidable
emergency admissions?
Chief Investigator
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Institution
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Dates
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Funding Stream
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Grant Ref
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Amount
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Dr Sarah Voss
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University Hospitals Bristol NHS Foundation Trust and University
of the West of England, Bristol
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01/09/2016 - 28/02/2018
(18 months)
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Research for Patient Benefit (RfPB)
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PB-PG-0215-36098
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£149,790
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Summary
Older people with multiple health problems often call a 999
ambulance. Where one of these health problems is dementia, the risk
of ambulance use, A&E attendance and hospital admission are all
increased. It is important to try and reduce this, as patients with
dementia tend to have poor outcomes when they are taken to A&E
or admitted to hospital unnecessarily.
This study aims to find out why older people with multiple
health issues including dementia are taken to hospital by
ambulance, instead of being treated in the community. This will
build on earlier work to find the true burden of dementia on
pre-hospital care. It will look at the length of time paramedics
spend at the scene, factors guiding the decision to transport and
alternatives to A&E visits and hospital admissions.
There will be 3 phases of work:
Phase 1: Analysis of existing ambulance service data from
previous 999 calls.
Phase 2: Observations of ambulance call-outs to patients with
multiple health problems including dementia.
Phase 3: An assessment of what could be provided in the
community to avoid hospital admission.
This proposal is part of an overall research plan, and will
inform further investigations and future service delivery. We plan
to study issues specific to the ambulance service that reduce or
increase the risk of someone with dementia and other long-term
health conditions requiring hospital care, rather than being looked
after in or close to their own home. It contributes to a larger
piece of work developing and evaluating safe and effective
alternatives to hospital admission for people with dementia. This
will lead to a reduction in the number of avoidable emergency
admissions, and better patient outcomes, for example through the
introduction of rapid response health and social care teams as
described in the NHS Five Year Forward View (2014).
Pump Priming
Preliminary data to support the application for this grant was
generated by a UH Bristol Research Capability Funding
(RCF) pump priming grant. Please visit
http://uhbristol.nhs.uk/research-innovation/our-research/above-and-beyond-research-capability-funding/completed-grants/recognising-and-responding-to-cognitive-impairment-in-emergency-care/ for
further details of this grant.