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Treat the person, not the diagnosis
Innovative use of technology has enabled Orchard Care Homes to offer a better quality of life to its residents as well as cut costs
Treat the person, not the diagnosis – how digital tech is helping improve residential care
7th December 2022about a 6 minute read
“Just because you walk into a care room doesn’t mean your life’s over.”Cheryl Baird, group director of quality at Orchard Care Homes
Cheryl Baird, group director of quality at Orchard Care Homes, firmly believes that residents in a care home can lead happy and fulfilling lives. “Just because you walk into a care room doesn’t mean your life’s over,” she says. While many people see care homes as places where residents sit around waiting for a cup of tea, Orchard, she adds, is “determined that that is not going to be the experience of people living in our care homes.”
One of the ways in which Orchard is improving care for its residents is through intelligent use of technology. The company, which runs 23 care homes in England with 1,200 residents, has approached digitisation not just as a means to improve efficiency and eliminate paper-based processes, but to offer better quality of life and outcomes for its residents.
The organisation is now “fully digital,” with digital care records, electronic medication and administration recording (eMAR), digital audit and feedback and, most innovatively, Pain Check – artificial intelligence software that monitors patients’ pain levels. The software used by clinical staff (medication charts, care plans, pain assessment and audit) is all held on a single device to make it easier to use.
Reducing medication use
The provider’s major achievement has been to use data analytics to make changes that have radically improved residents’ experiences. Both eMAR and Person Centred Software, the electronic patient record, have made it easier to record and access information. But they also provide a rich source of data about patients, says Cheryl: “I can see who’s had their medication, who hasn’t had their medication, how much medication people have had and what type of medication they’re taking.”
Having that information provided an opportunity to review the medicines residents were taking. “We were really keen to reduce polypharmacy. Older people are just prescribed so many medications,” Cheryl says.
Cheryl gives the example of a patient who kept being prescribed pain relief medication, which was ineffective in controlling their pain. “We were able to show all the data from their medication charts, their care plans, their pain scores to say, ‘This isn’t working, let’s look at it again and really scale back.’ This person’s on one patch now, as opposed to a ton of medications every day, so they [GPs] are starting to use the information that we’re giving them.” The consequence is that in the space of a year, Orchard reduced required medications by 48%.
One of the particular challenges of dementia care, says Cheryl, is that residents are often prescribed antipsychotics because it’s assumed that aggressive or disturbing behaviour is the consequence of their dementia. In practice, that isn’t always the case: “We’ve spent a year researching and developing ways to reduce antipsychotic use and look at the person rather than the diagnosis.” Rather than give a patient antipsychotics in response to certain types of behaviour, the solution is to find out the cause of the behaviour and to support them. Antipsychotic use across the whole organisation has reduced by 6% in a year.
Some GPs, she says, have been resistant to change, but those who have seen the positive outcomes are coming round: “We are getting more GPs and multidisciplinary team members working with us and understanding what we’re trying to do. It can be a bit of a battle, but we’re plodding on, and some have really embraced it and asked for various bits of data every months before they come out.”