Covid Supported discharge: A Liverpool experience

Clinical Research Results Abstract Research Idea Abstract Service Development & Evaluation Abstract outlineThe Liverpool Community Respiratory Team (CRT) from England is a well-established multiprofessional team who support patients at home with an acute exacerbation of COPD to safely avoid hospital admission (Davies et al, 2000). The team also provides admission avoidance, difficult diagnosis and optimisation clinics to support Primary Care.AimThe arrival of Covid 19 provided an opportunity for CRT to evolve, offering a new service to ensure high quality care was provided for patients recovering from Coronavirus regardless of a pre-existing respiratory condition.Description of change/intervention including strategy for change/impactPatients who were hospitalised with covid pneumonia were cared for 10 -14 days on discharge from hospital. CRT utilised existing links with Telehealth to enable patients to enter their observations 3 times daily and be reviewed in real time by CRT nurses. Patients were issued with electronic sphygmanometers, oxygen saturation monitor a tablet device preloaded with software or phone app to transmit readings. Patients were also contacted daily to review their progress. Day 3- 5 of their CRT care the patients were assessed by Physiotherapy team and taught chair based exercises by video link to start rehabilitation and refer to local Covid 19 pulmonary rehabilitation programme. Lessons learnedCRT supported 157 patients over a 12 month period and feedback from patients and consultant follow up clinics was very good. Of the 157 patients supported, 11 patients (7%) were readmitted, however 4 (2.5%)of these admissions were non-covid-related. 4 (2.5%) withdrew. 1 died. Safe monitoring and identifying deteriorating patients was the primary outcome, however it was identified that support of psychological symptoms and physical rehabilitation was also important for recovery. The pilot has informed and prepared the team for further “ waves” and provided valuable knowledge to future management by other teams. Declaration of Interest none References and Clinical Trial Registry Information Davies, L., Wilkinson, M., Bonner, S., Calverley, P. M., & Angus, R. M. (2000). "Hospital at home" versus hospital care in patients with exacerbations of chronic obstructive pulmonary disease: prospective randomised controlled trial. BMJ (Clinical research ed.), 321(7271), 1265–1268. https://doi.org/10.1136/bmj.321.7271.1265