Abstract

The Quest for Quality scheme was introduced with the aim of reducing hospital admission rates from care homes through interventions conducted by a multidisciplinary team (MDT). The objective of this was to study the types of interventions being made and establish their impact. The data was collected directly by the MDT prior to the research and therefore the analysis was retrospective. Exclusion criteria were set for each part of the analysis, taking into account missing data. A flow chart based on situations was developed allowing interventions to be classified into British National Formulary (BNF) categories and then assigned a priority. The categories found to have the most interventions were related to the gastrointestinal system (140) and to nutrition and blood (128), findings that were anticipated due to the medical issues arising in the elderly. One of the major problems identified was in the follow-up of interventions. Overall, 35% of intervention outcomes were unknown and only 20% were actioned. Reasons given for this were issues with patient record systems and the interventions not being received by the prescriber; a system allowing interventions to be tracked was therefore suggested. The causation between increasing reviews and decreasing hospitalisations could not be proved (Pearson correlation=−0.983, CI 95%) due to insufficient data. It was, however, shown that the MDT were making appropriate and valuable interventions, contributing to a reduction in polypharmacy and better quality of care when taking into account the specific case studies identified. With Quest for Quality now recommissioned, it will continue to make improvements to the benefit of patients.

Keywords

Polypharmacy; multidisciplinary team; intervention; care home; deprescribing.

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