Functional Summary Tool Kirsty Forrest Patient Flow Coordinator

Functional Summary Tool Kirsty Forrest Patient Flow Co-ordinator Dumfries & Galloway Royal Infirmary kirstyforrest@nhs. net

REASONS FOR REFERRAL • Ward Team • Patient Flow For REHAB For rehab What sort of rehab ? Its complicated Its xx days post surgery This is an acute ward FOR REHAB What intensity of rehab ? What's the patients’ goal? What is the anticipated outcome ? Is the patient ready to move ? What is preventing discharge home?

Representation of Process Admitted to ward Medical Assessment Nursing Assessment / Intervention OT Assessment Physio Assessment Refer to Patient flow at any time during Process Day of Admin Ongoing

Functional Assessment Summary Tool • Medical Assessment – Clinical Frailty Scale • Cumulated Ambulation Score • CAS interpretation • Patient Centred Goal – with time scale • Record of patient involvement • Comments

Representation of New Process Admitted to ward Medical Assessment Nursing Assessment / Intervention Physios start CAS OT Assessment CAS Day 2 CAS Day 3 CAS Interpretation Therapeutic Goals Assessment Conclusion Patient Flow Day of Adm Day 4

Patients Discharged Home 70. 0% Patients discharged home Median Baseline 60. 0% 56% Percentage 50. 0% 40. 0% 36% 30. 0% 20. 0% 10. 0% March April May June Months 2017 Started document testing July August September

Length of Stay In Acute 60 Min range of days in DGRI Max range of days in DGRI 50 Days 40 30 20 10 0 March Months 2017 April May June Started testing July August September

STANDARDISED TOOLS • Clinical Frailty Scale • Rockwood K, et al. A global clinical measure of fitness and frailty in elderly people. CMAJ 2005; 173: 489 -495 • The Cumulated Ambulation Score (CAS) • Foss NB, Kirstensen MT, Kehlet H. Predication of postoperative morbidity, mortality and rehabilitation in hip fracture patients: the cumulated ambulation score. Clinical Rehabilitation. 2006; 20: 701 -8