‘Information About Me’: Valuing the missing link
Dr Kyra Neubauer is a Clinician for the Complex Assessment and Liaison Service at North Bristol NHS Trust.
Geriatricians know the value of holistic assessments and the need to understand the functional status and social situation of the patient. Despite this, we also recognise that discharges are often delayed, with consequent risks of functional decline, and patients and families being left feeling their needs have not been adequately met.
This prompted me to approach the National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) and partners to design a study which aimed to identify the barriers to discharge of frail older patients.
We undertook qualitative research to observe clinical care in two large teaching hospitals in Bristol and Birmingham, following the patient journeys of 37 frail older patients from admission to discharge, in both Care of the Elderly and other medical settings. Multiple interviews were also carried out during the research; talking to patients, carers and staff from all disciplines about their views on their care, and the facilitators and barriers to discharge.
One of the main findings of our research was that although staff did ask patients and carers about the patients’ home circumstances, level of functioning and care provision, this information was either not formally recorded, inadequately recorded, difficult to find or not recorded at all. Information was often recorded by a number of different individuals, in different formats and with different emphases. Patients and relatives found this to be both frustrating and concerning, as it made them feel that staff were not communicating effectively and this led to their losing confidence in the care arrangements. Even when this information was available, its value was not always appreciated.
On the occasions when the recording of this information was done well, was readily available and the staff used the information, this was appreciated by patients and carers and resulted in better and more prompt discharges.
Based on our research, we have produced an animation which aims to highlight, to patients, carers and staff, the importance of ‘Information About Me’. The animation links to a downloadable form that can be used by patients and carers to record important information. This can then be supplied to staff when patients are admitted and can be used to aid the discharge process.
By encouraging patients and carers to record this information and recognise its value, not only do we hope to reduce the time staff take collecting it, but also to increase the appreciation of ‘Information about Me’ in facilitating safe, patient-centred and timely discharges.
Watch the animation below and download an example of an ‘Information About Me’ form here.