Care Virtual Ward Donegal wins HSE Excellence Award

CARE Virtual Ward Donegal has won a HSE Excellence Award in the Improving Patient Experience category.

The awards took place in Dublin on Thursday November 28th. Here is a video detailing the work of the Care Virtual Ward- https://www.youtube.com/watch?v=1Os5_4RNgBU

Patients with exacerbating Chronic Obstructive Pulmonary Disease (COPD) often require multiple admissions and readmissions to hospital. In 2021 data from Letterkenny University Hospital (LUH) highlighted that 28.7% of patients admitted with COPD were readmitted to hospital within 30 days of discharge.

CARE Virtual Ward (VW) opened in November 2023 for patients with COPD in Donegal to offer an alternative care pathway. The overall aim of the CARE VW is to give patients who are experiencing an exacerbation of their COPD the choice to receive the care they need safely at home monitored by experienced nurses and physiotherapists and supported by technology.  It also facilitates those who require to be treated in hospital to be discharged earlier with support from the Respiratory Integrated Care Team (RIC) team, allowing them to recover in the comfort of their own homes.

Patients are educated to recognise early deterioration of their condition and are provided with a prescription for antibiotics and steroids termed as a rescue and are instructed on when and how they are to be used. 

CARE VW provides patients with wearable technology that records their respiratory rate, pulse and oxygen saturations. They are also given an electronic tablet with an app developed by the RIC team so that their information can be sent from their home to their clinician. They are shown how to use the equipment as well as the electronic tablet.  This easy to use technology allows the RIC team to monitor the patient’s condition and to detect any deterioration so that they can follow up as appropriate. The service is provided by the RIC Team in Donegal with governance from the Respiratory Consultant in Letterkenny University Hospital (LUH).

Janet Given, Patient Representative said; “It was an absolute education, I never realised what I would be learning.  I would recommend anyone to go for it, anyone who is diagnosed with COPD.”

CARE Virtual Ward has enhanced team work and improved communication between acute and community teams in caring for patients. The RIC team have developed clinical pathways with the Acute Respiratory Consultant, acute respiratory clinicians, GP’s, and the National Ambulance Service (NAS).

A multidisciplinary team (MDT) ‘daily huddle’ at which patients are discussed, enables the delivery of safe effective patient care. If intervention is necessary it is decided at these meetings and the relevant team member is assigned.

Weekly Consultant MDT’s were established to give a forum for patient care to be discussed and plans of care are reviewed. This has significantly improved patient outcomes.

The community paramedics support the RIC team. Outside of CARE VW working hours a ‘watch list’ is devised by the CARE team and communicated to NAS. They can then support any calls from patients on the CVW directing them to community paramedics for review where appropriate, with the aim to avoid a hospital admission. To date there have been 25 patients reviewed by the Community Paramedics and 80% of these individuals have remained in their home.

Since the commencement of the CARE VW in November 2023 there has been a 22% reduction in overall admissions to LUH for patients with a presenting complaint of COPD. In addition to this the readmission rate has reduced from 27.8% to 13.8%. 193 patients have been treated for exacerbations of their COPD, relating to 853 acute bed days saved in LUH.

Aside from the hugely positive data, patients have been linked into other aspects of the RIC service e.g. oxygen clinics, pulmonary rehabilitation programmes which assist them to remain well and improves their overall health outcomes. 100% of patients who have been admitted to the CARE VW have reported an increased understanding of their COPD.

Receiving the HSE Excellence Award in the Improving Patient Experience category, Mandy Doyle, Head of Service Primary Care, HSE Community Services Cavan, Donegal, Leitrim, Monaghan, Sligo said “This fantastic achievement is most deserved and a true recognition of all the hard work and efforts of the CARE Virtual Ward Team.”

Dr Olga Mikulich, Respiratory Consultant at LUH said “The programme has led to a reduction in those being admitted to LUH with a COPD complaint and it is wonderful to see this acknowledgement by means of the Healthcare Excellence Award.”

Liam, Patient testimonial: “Honestly, it’s hard to put into words what it has done for me, it’s just changed my life.”

Photo caption:
Brian Gillespie, Advanced Paramedic, National Ambulance Service (NAS) and Claire McRory, Operational Team Lead, HSE Chronic Disease Management Donegal at the Health Excellence Awards ceremony.