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Who’s in the beds? Experience of using the AEP in the UK. Paul Forte ORAHS Working Group Prague, July 2003. Coming up shortly…. Brief overview of the AEP (Appropriateness Evaluation Protocol) Illustrative results from a recent project using the AEP
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Who’s in the beds?Experience of using the AEP in the UK Paul Forte ORAHS Working Group Prague, July 2003
Coming up shortly… • Brief overview of the AEP (Appropriateness Evaluation Protocol) • Illustrative results from a recent project using the AEP • Issues concerning the application and extension of the AEP
What is the AEP ? • A validated protocol used to determine: • the ‘appropriateness’ of acute admission • the continued occupation of acute beds • Enables exploration of the potential for alternative care and treatment pathways • Based on data from patient notes
Why use the AEP ? • Efficiency • Contributes to a whole systems analysis • Identifies potential service improvements • Quality • Appropriate care and locations for patients • Re-orientates focus of services • Modelling • Provides quantification (‘who’s in the beds’) and support for capacity planning
295 out of 661 acute patients (45%) were not receiving care within AEP criteria on the day of the survey
Hospital types and rehabilitation • Acute, ‘non-acute’, and community hospital wards • Types of rehabilitation: • recuperative (‘convalescence’) • restorative (eg. post fractured neck of femur) • reconstructive (eg. post stroke)
The AEP experience • Establishing survey objectives • Survey ‘mechanics’ • Reporting findings and local buy-in • Using the results • Engaging key players
AEP – what next? • Broadening the AEP scope • Development of rehabilitation and ‘sub-acute’ care criteria • Updating for clinical practice changes • Embedding results • A fundamental issue in ‘OR’ • Patient and referring clinician views
What the AEP effort contributes to modelling the whole system?