The discharge to assess pathway is something we launched at Active Pathways 5 years ago with incredible success. The 12-week care pathway has proven successful with many of our residents that didn’t require a long-term treatment plan, and were comfortable with a route that aims to relearn skills and get back in to the community at a faster pace.
What is the D2A pathway?
Discharge to Assess is a 3-month recovery pathway, aimed generally at individuals that have been discharged from hospital after previously living relatively independently in the community. This condensed treatment plan is ideal for someone who no longer requires an acute bed, but would benefit from additional support whilst they step down. This support can take many forms and depends entirely on the individual and the skills that they need to learn in order to live safely and independently in the community.
“When people come to one of our services for a D2A stay, we make sure we tailor the treatment plan to the individual, this means we focus on whatever their specific needs are, this could be anything from medication management and financial skills, to cooking and personal hygiene”
In addition to these skills-based interventions, the team at Active Pathways also promote learning coping strategies and ensure all residents have an understanding of their own symptoms and triggers, allowing them to recognise when and how they might need to seek advice, and strengthening their chances of avoiding future crisis admissions.
Benefits of D2A
Following a D2A pathway as an alternative to discharging service users straight back into the community comes with a whole host of benefits. It promotes community reintegration through confidence and skill building, reduces pressure on acute and out of area beds, and reduces costs to the NHS. Furthermore, D2A pathway helps remove services users from acute setting that can be more distressing due to higher levels of acuity as well as providing a calmer and less restrictive environment with more resources for one-to-one care and support.
Discharge to Assess clinical pathway has a duration of 12 weeks, this period is made up of assessment, support, treatment and recommendations and if successful, aims to discharge service users to a community setting with any future support package in place. MDT collaboration is imperative at every stage and ensures appropriate and effective discharges.
Outcomes at Brookhaven
19% of service users no longer access services in the community
90% of service users were discharged in to the community either to their own home or a supported living setting with community team support
Only 3% require ongoing rehabilitation at Brookhaven
64% of service users remain in the community