Background
Acute paediatric admissions have been increasing year-on-year with unsustainable financial and organisational implications for the NHS. The reasons for this are not yet fully understood and evidence is unclear.
Various interventions have been introduced within paediatric acute care settings in the South West to try and improve service delivery and reduce both unnecessary unplanned admissions and the number of children and young people presenting to hospital in need of urgent care.
Phase 1- Children’s Urgent Care Redesign Group Project
We collaborated with a local hospital in the South West to design and implement a Paediatric Assessment Unit (PAU) service, designed to manage paediatric cases within the emergency department. The aim of the work was to reduce unnecessary admissions of children to the hospital wards. Other aims included reducing the amount of time that children spent in the emergency department (ED), enabling children to receive the care appropriate to their needs and in the appropriate environment. Setting up a PAU within the hospital demonstrated at 17% reduction in admissions. As part of this work we have produced a systematic review on the effectiveness of interventions which has been published in the British Medical Journal (see publications below).
Phase 2- Paediatric Acute Care Project
Building on the work that we did in phase 1, the Paediatric Acute Care project will: a) record interventions used in the South West region with the aim of examining the impact that they have on service delivery, and b) measure effectiveness of interventions on acute paediatric attendances, admissions and length of stay.
Professor Stuart Logan discusses this project in the video above.
Project aims
The overall aim of the work being carried out in phase 2 is to improve acute paediatric care rather than to simply reduce admissions. The two main aims of the Paediatric Acute Care project are to:
1) Facilitate system level service improvement
2) Review the information collected to see whether interventions at the system level can improve acute care and reduce admissions rates
Publications
Thompson-Coon J, Martin A, Abdul-Rahman A, Boddy, K, Whear R, Collinson A, Stein K, Logan S. Interventions to reduce acute paediatric hospital admissions: a systematic review
Husk K, Berry V, Tozer R, Skipwith G, Radmore R, Ball S, Ukoumunne O, Logan S. Interventions for reducing unplanned paediatric admissions: an observational study in one hospital BMJ Paediatrics Open