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Future Hospital: Caring for medical patients

Future Hospital: Caring for medical patients. Context and development. Why establish the Commission?.

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Future Hospital: Caring for medical patients

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  1. Future Hospital: Caring for medical patients

  2. Context and development

  3. Why establish the Commission? ‘I was moved five times, all done at night time, some of them with nurses wheeling me down corridors with all the contents of my cabinet on my knee. It is very impersonal. You feel like a package.’RCP Patient and Carer Network member

  4. Why establish the Commission? ‘My trust does not function well at night and I am relieved on Monday that nothing catastrophic has happened over the weekend’ Hospital doctor’Hospital consultant

  5. Why establish the Commission? ‘We need to take responsibility for every patient who comes through the hospital door. Consultants need to reclaim responsibility for all aspects of medical care, whatever their speciality.’Hospital consultant

  6. Why establish the Commission? Hospitals on the edge? • Rising clinical demands • Changing needs • Fragmented care • Out-of-hours care breakdown • Medical workforce crisis

  7. Time to reflect • Do you know how often your patients are moved in the middle of the night? • Do you know how often the same patient is moved – not necessarily at night? • How often does a patient have to repeat his or her personal information and medical history? • Is the language used in your organisation appropriate? • Are you satisfied that there is enough senior decision making at the front door?

  8. Establishing the Future Hospital Commission

  9. Constitution of the Commission

  10. What does the report cover? • Organisation of medical care and teams • Education, training and deployment of medical staff • Building a culture of compassion and respect • Management, economics and leadership • Information systems

  11. Recommendations

  12. New principles of acre • Eleven principles of patient care, including: • Patient experience valued as much as clinical effectiveness • Clear responsibility for each patient’s care • No wards moves unless necessary for clinical care • Robust arrangements for transferring of care • Self-care and health promotion facilitated. • Care plans that reflects individual needs for all

  13. A new model of hospital care • Medical Division • Acute Care Hub • Clinical Coordination Centre

  14. Care where patients need it • Clinical leadership for safety, outcomes and experience • Medical care coordinated by single consultant • Specialist medical teams work: - across wards - at the ‘front door’ - into the community • To deliver: • early assessment by senior doctor • ‘fast-tracking’ to specialist wards • ‘same day’ emergency care • early care planning

  15. Care across seven days • Consultant presence on wards over seven days • Team rotas designed over seven days • Arrangements for leaving hospital across seven days

  16. Education, training and deployment • Internal medicine valued and promoted • More participation in (general) internal medicine • Training in internal medicine across specialties • Structured training for internal medicine • Clinical workloads regularly reviewed • Non-elective medical care prioritised in: - job plans - financial structures

  17. Information supporting care • Patient-focused clinical records • Single electronic patient record • Common record standards • Viewable in hospital and community

  18. Reaction and next steps

  19. Reaction ‘Most important statement about the future of British medicine for a generation’ ‘the result could be a step change in the quality of care’ ‘Doctors propose cure for failures on wards’ Welcome to the hospital of the future ‘…bold and refreshing’

  20. Impact

  21. Realising the Future Hospital RCP Future Hospital Programme (2014-2017) • improve care for patients • develop and implement vision - medical care in hospital and community • drive real change - recommendation to reality • work in partnership with: - patients - individual hospitals and teams • partners across health and social care (FH strategic advisory group) • national stakeholders

  22. Realising the Future Hospital • Consult • Future Hospital partner sites • develop model • understand implications • identify barriers and changes • promote and mentor • Promote good practice - Future Hospital Journal • Influence - identify levers in new structures • Embed in existing RCP work

  23. Questions? www.rcplondon.ac.uk/futurehospital futurehospital@rcplondon.ac.uk

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