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Elastomeric Devices: Delivering IV antibiotic treatment in patients’ homes

Summary

Elastomeric devices are small pumps used to administer medication such as intravenous (IV) antibiotics or chemotherapy, which can play an important role in giving patients the best possible care. They can be used in patients’ homes and, consequently, could help relieve pressure on hospital beds by reducing admissions and facilitating earlier discharge of patients whose sole reason for remaining in hospital would be to receive IV antibiotics. With an elastomeric device at home, patients who might need antibiotics several times a day can safely have a single visit from health professionals. During the pandemic there were additional benefits from looking after patients safely outside hospital.

This is a local project in partnership with Oxford University Hospitals (OUH) which has introduced elastomeric devices into clinical practice. The project originated from a student from OUH who completed the Adopting Innovation and Managing Change in Healthcare Settings programme run by the Oxford AHSN and Bucks New University. Following successful implementation of the devices at the OUH, the Oxford AHSN is working with the OUH team to develop a local project that supports other trusts in the region interested in introducing elastomeric devices.

What’s the challenge and solution?

Pressure on inpatient hospital beds is a longstanding issue – and one that has taken on greater significance through the pandemic. Alternative ways are being actively sought to treat patients safely and appropriately without needing to admit them to hospital or that reduce the time they spend in a hospital bed by facilitating safe discharge at an earlier stage in their recovery.

Elastomeric devices are small, single use pumps used to administer medication such as intravenous (IV) antibiotics or chemotherapy. Because they can be used at home, they have the potential to help to relieve pressure on hospital beds for patients who would otherwise remain in hospital just to receive IV therapy. The pumps can also support patients to remain at home and avoid admission.

What did we do?

The Adopting Innovation and Managing Change in Healthcare Settings programme is a Masters-level course delivered by the Oxford AHSN and Bucks New University, providing students with the information, skills and support they need to introduce an innovative idea into practice within their organisation.

Sophie McGlen portrait

Sophie McGlen

Since it started in 2016 more than 200 NHS innovators have completed the programme. One of them is Sophie McGlen, Ambulatory Care Lead Pharmacist at Oxford University Hospitals (OUH), who applied her learning to initiate a local project introducing elastomeric devices into clinical practice, working with ‘hospital at home’ nursing teams to provide IV antibiotic treatment in patients’ homes. This approach helps to avoid unnecessary admissions and supports earlier discharge from hospital. The Oxford AHSN has worked with Sophie and her team to understand the impact of the new pathway on length of stay, hospital bed days saved and patient experience.

Sophie said: “I have been hugely supported by the Oxford AHSN to roll this out, and the course really helped me with the governance process. We would not have got where we are without them.”

Impact/outcomes

From December 2019 to September 2021, 86 patients were discharged with the device to complete their IV antibiotic treatment at home. As a result over 1,100 bed days were released, equating to net cost savings to OUH of £360,410. Feedback was gathered from patients with a significant majority saying they were very happy with the device and would use it again.

Future plans

The Oxford AHSN is working with the OUH team to develop a local programme that supports other NHS hospitals in the Oxford AHSN region interested in introducing the devices. This includes developing an implementation support document, produced in collaboration with the OUH, which describes the journey undertaken to introduce the devices into clinical practice, training and governance requirements and lessons learned. This work will also include looking at other potential medicines that could be used with the device and thereby expand the number of patients who could benefit.

The Oxford AHSN has secured funding from Health Education England to support roll out across the South East of England, including clinical leadership and webinars for NHS trusts to understand more about the different models of care that could be adopted, operational considerations and support for introducing the devices into practice.

The OUH and the Oxford AHSN have also worked with NHS Supply Chain which looked at this project as part of its Value Based Procurement programme. This programme shifts emphasis from reducing product costs to looking at reducing total costs within a patient pathway. NHS Supply Chain published a case study based on this work in January 2022.

Contact

Alison Gowdy, Clinical Innovation Adoption Manager alison.gowdy@oxfordahsn.org