Day 2 of the tour took us first of all to Lund in Sweden. Here we visited a Patient Hotel that had been running for nearly thirty years, co-located on the main hospital site. What was becoming apparent on the tour was that the title Patient Hotel hides a myriad of models and approaches – and the mantra of flexibility underlined at day 1 of the tour was a truism for today’s visits as well.
The Lund hotel catered for a very varied range of patients. The manager and the team were all nurses, and offered what felt like a strongly nurse led engagement with the patients. There was a defined cohort of patients who came to the hotel for up to six weeks at a time whilst they received intensive cancer treatment. Patients were intended to be largely self-managing, but the presence of nurses at all times ensured that questions and queries raised by patients about their treatment, or in relation to wider health concerns could be easily accommodated, and the nurses were able to keep a watching brief on patients to quickly identify deterioration or the need. In an interesting twist to the model, this hotel also had a dedicated floor for maternity patients – where those who had completed a planned and ‘straightforward’ delivery then came into the hotel for two to three days to recover and gain some additional support.
Whilst the ethos was orientated around people being able to manage for themselves, there was also a strong encouragement for people to come to the hotel with a family member – who could then offer them support in the day to day activities around dressing and hygiene. There was a number of people coming into the hotel for post- and pre-operative care, and some who were in need of IV antibiotics etc… but the largest cohort were those needing to be close to the hospital for regular attention. So – the big learning point here was around the geography – and what a significant factor this has been in the development of the model.
In the afternoon we returned to Copenhagen to visit the Patient Hotel at Rigshospitalet. This very modern purpose built hotel had the look and feel of a modern Extra Care Setting/Hotel. Light and bright atrium led to spacious and stylish rooms, all designed by Danish architects and featuring Danish fixtures and fittings. This was again a nurse led model – with patients being directly referred to the hotel, and then a cross subsidy passed back to the ward. Again, there was a predominance of patients from oncology, and a smaller number who were resident in the hotel whilst they received specialist physiotherapy from within the hospital. The new design had a number of enhancements which built on the learning from across the country, including the introduction of fully accessible rooms, family rooms and a much larger number of double rooms to accommodate family members to support the patient to manage independently within the hotel environment.
Again, the geography of Denmark played it’s part in determining the guests at the hotel, with accommodation provided primarily for those who were living over 100Km away, and for whom the regularity of treatment at the hospital meant that traveling back and forward was not feasible.
Reflecting on the day – it is easy to see the attraction of the model in Sweden and Denmark. Patients who do not need regular medical attention, and are able to manage independently, can be accommodated safely and in close proximity to their regular treatment base at a fraction of the cost of them remaining within the ward environment. It is also very clear that being able to have a quiet, calm and attractive place, with privacy as required and a community of peers for support when wanted, is likely to have a positive impact on patient outcomes.
I feel that I have seen the title ‘patient hotel’ used to mean three very different offerings – which all have a different spin on them in terms of target audience, size, environment, length of stay, levels of medical intervention, connection to patient records, staff to patient ratio and outsourced vs in house provision – amongst other things! However, whichever model you looked at, what they seemed to offer each and every one of the communities they served was desperately needed capacity, a more positive environment for the patient, a flexibility that accommodated changing practice and priorities and a critical bridge for individuals and families between hospital and home. With those ambitions in mind – our job for tomorrow is to scope out what a relevant equivalent service in the UK might provide amidst our traditional health and care offerings. Watch this space….
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