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IRIS

IRIS. New Developments August 2005. Target Areas. In April 2002 when IRIS was established the identified areas that the team targeted were Accident and emergency Acute Medicine Acute Surgery Medicine for the Elderly Rehab Medicine for the Elderly Assessment Nursing Care Home Liaison

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IRIS

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  1. IRIS New Developments August 2005

  2. Target Areas • In April 2002 when IRIS was established the identified areas that the team targeted were • Accident and emergency • Acute Medicine • Acute Surgery • Medicine for the Elderly Rehab • Medicine for the Elderly Assessment • Nursing Care Home Liaison • GP Rapid Response (West team only)

  3. Service Data April 2004 – March 2005 • TOTAL NUMBER OF PATIENTS INCLUDED – 2,638 • Patients included from A&E including out of hours – 278 • Patients included from Acute Medical Receiving – 56 • Patients included from General Surgery - 62 • Patients included from Orthopaedics (Trauma/Elective) – 478 • Patients included from Medicine for the Elderly(Assessment) – 345 • Patients included from Medicine for the Elderly(Rehabilitation) – 468 • Patients included from Stroke (Acute Ward) – 90 • Patients included from Stroke (Rehabilitation) - 143

  4. IRIS West • DAY SURGERY: • Scarf Osteotomy • Figures to date January 2004 to August 2005 = 19+ patients • Patient screened in Day Surgery Unit • Discharged home with local anaesthetic pump which lasts 4 hours • Visit 1st post-op day • 10th post-op – patients with Go surgery re: suture removal • This group of patients were in hospital 3 days prior to this event

  5. IRIS West • DAY SURGERY: • Shoulder Decompression • Under discussion at present, it is envisaged that protocol will be agreed to allow this development to take place.

  6. IRIS East • DAY SURGERY: • Arthroscopic Frozen Shoulder • Arthroscopic Shoulder Decompression • ‘G’ grade secondment into IRIS for 4/12 for this new development • Assessment in Day Surgery Unit and IRIS interventions 1st/2nd post-op days

  7. IRIS East • MEDICAL TRIAGE • Acute Medicine • 6 months ‘G’ grade secondment to triage from acute medical to care of the elderly assessment and rehab

  8. Across 3 Sites – North/East/West • GP RAPID RESPONSE • Admission avoidance • Now available across the 3 sites • GP’s refer directly to teams • In the past 12 months – 267 patients taken on • STROKE/IRIS • All these posts are .5 or .4 posts • Patients taken on from • Stroke Rehab Wards • Acute Stroke Units • 283 in 1st year

  9. Appropriate Bed Admission • NOW AVAILABLE • The opportunity to transfer patients from A&E directly to Elderly Care Assessment bed • (When said beds are available) • Patients referred to IRIS from A&E assessed in department by team member • Team member contacts on-call elderly care Registrar and directly transfer if bed available

  10. Social Work • Quarterly meetings with social work colleagues regarding joint working and a shadowing programme to allow us each to have a greater understanding of each others role in discharge • Social Care workers now located within each IRIS Team

  11. Carefirst • IT system used in Glasgow City Social Work • Pilot to be carried out in West (read only access) Initially • Then pilot to be active in East and North

  12. COPT • Quarterly meeting with COPT coordinators • We refer patients on to this service who have 2 identified needs and their rehab programme has not been completed within our four week involvement

  13. Satisfaction Surveys • We send patients and GP’s who use IRIS satisfaction surveys • Snapshot surveys reveal a 90% satisfaction level • Although 1GP (who will remain nameless) complained he disliked the service as he was made to visit the patient more frequently

  14. Pharmacy • Staffing now present in all 3 teams • Improved link with Primary Care and Pharmacy Services • Development of medication leaflet

  15. Current Evaluation Facts 2004-05 • Largest group of patients seen 80-90 years • 5% of patients are under 60 (Stroke Unit and Orthopaedics) • 97% patients received up to 20 visits from the team in a 4/52 period • 55% of all IRIS patients had falls risk assessments completed • 65% of patients improved in Nottingham & Tinetti score over 4/52 period • Medicine for the Elderly Acute and Rehab and orthopaedics remain largest referrers to Service

  16. In Summary “To travel hopefully is a better thing than to arrive, and true success is to labour” Robert Louis Stevenson In IRIS there is lots of labouring done by a very dedicated band of nurses and allied healthcare professionals, our new developments highlight our commitment to admission avoidance. Yes we still don’t cover every clinical area in North Glasgow but do believe that we need much larger teams and to get that we need finance from these clinical areas.

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