Can technology help solve a very human problem?
Hospital discharges: work/ health/ tech/ humans
I caught up with Debbie Harris, Managing Director and Founder of Autumna, a technology platform deployed alongside expert human support to help people find residential care. We spoke about using technology to meet demand in health and social care. Technology can automate administrative and operational workstreams, allowing the human health and care workforce to do what they do best.
The challenge
Hospital discharge teams are stretched trying to communicate with care providers about placements for patients. Multiple patients on a ward may be awaiting care in the community, all with different personal priorities, different care needs, with different funding arrangements and different budgets. Often, discharge teams are tasked with manually searching and contacting providers to look for a suitable placement. The delay in outreach and response can mean a change in provider availability as well as patient level of need while the patient waits. This is a dynamic challenge. While there are definitely staffing shortages and other resource constraints in social care, many providers do have availability that is not being utilised. Finding appropriate care is the first rate-limiting step after pre-discharge assessment.
The consequences
Delayed transfers of care have a negative effect on patients who are well enough to leave the acute environment, as well as family and friends around them. Delayed transfers of care account for the majority of delayed discharges, which affect flow through the hospital. In December 2022, more than 10% of hospital beds in England were occupied by patients who were fit for discharge- over 13000 patients. Delays are more likely for people requiring residential than home care. Resource throughout the hospital is stretched, leaving reduced capacity to assess, treat and admit more patients coming through the front door. This has an effect on hospital staff who struggle to keep up with demand.
What technology can and cannot do
Conversations and assessments around changes in function, changes in care needs, changes in financial outgoings and changes in living arrangements after a period of ill health can be turning points in people’s lives. These conversations can be emotional, sensitive and must be facilitated by experienced professionals. Navigating the landscape of different social care providers and what they offer can be challenging without expertise. Humans are key in achieving good quality transfers to care.
What can be automated is the provider search and outreach. Technology is better and faster at searching, filtering and contacting providers by email than humans are at Googling, manually comparing and contacting providers- sometimes by telephone, where pinning down the right person can take days.
Autumna is an example of a platform that works with a database of subscribing providers. Care-seekers are asked for basic information around the type of care they are seeking, and are sent a shortlist of suitable providers. If they wish to approach any of the shortlisted providers, an automated email, with information about their needs, is sent on their behalf. Human staff work alongside technology at Autumna, guiding users who have queries or want to talk options through. For requests coming from NHS discharge teams, care providers are asked to respond with their availability within 60 minutes. This helps keep care moving forward. Autumna is an example of a technological solution that removes the operational challenges to finding suitable social care, allowing humans to focus on the human challenges.
Technology can be empowering
Technology can democratise a search for care. Though a solution that could help reduce the operational overhead of hospital discharge teams, Autumna can also be used by GPs, local authorities, social prescribers and other community health and care professionals and patients and their families to look for care themselves, whatever their current living or care situation. 75% of people that come through the platform are placed through the platform.
Systems impact
Over 1400 NHS patients have used Autumna for transfers of care from hospital discharge since January. It is difficult to estimate how many additional unnecessary days in acute settings were prevented by using the platform, but costs to the NHS saved during that time could be up to £2.5M. Removing the administrative overhead from the provider search and outreach helps health and care staff divert their resource to focus on supporting patients and their networks through the process. As well as financial costs saved, human costs are saved through patient and staff welfare.