BReATHE interventions (Beating Regional Asthma Through Health Education)—an innovative approach to children’s asthma care in the North East and North Cumbria, UK: an interventional study

2021 ◽  
pp. archdischild-2021-321644
Author(s):  
Jennifer Katherine Townshend ◽  
Sally Hails ◽  
Ruth Levey ◽  
Patty DeZwart ◽  
Michael McKean ◽  
...  

To objective of this project was to reduce unplanned hospital admission rates in children related to asthma to the Newcastle upon Tyne Hospitals National Health Service Trust (NUTH).Multiple educational interventions were introduced both locally and regionally including: a collection of educational materials aimed at young people and families, schools, primary care and secondary care on the website www.beatasthma.co.uk; regional training days; a nurse-led one-stop clinic; a new pathway following an acute attendance to hospital with an asthma attack; a local asthma service and cascade training for schools.The primary outcome measure was reduction in unplanned hospital admission rates in children due to asthma to the NUTH.Results showed that admission rates had been increasing at a sustained rate of approximately 30% each year in the 3 years prior to our intervention. After the Beating Regional Asthma Through Health Education interventions, unplanned admissions to NUTH reduced by 29% and this reduction has been sustained for the last 3 years. This compares with a regional increase of 10% over the same time period.In conclusion, simple but effective educational interventions resulted in a significant and sustained reduction in unplanned asthma admissions to NUTH. Further work is underway to extend the reach of these interventions into primary care and schools.

2021 ◽  
pp. 135581962110127
Author(s):  
Irina Lut ◽  
Kate Lewis ◽  
Linda Wijlaars ◽  
Ruth Gilbert ◽  
Tiffany Fitzpatrick ◽  
...  

Objectives To demonstrate the challenges of interpreting cross-country comparisons of paediatric asthma hospital admission rates as an indicator of primary care quality. Methods We used hospital administrative data from >10 million children aged 6–15 years, resident in Austria, England, Finland, Iceland, Ontario (Canada), Sweden or Victoria (Australia) between 2008 and 2015. Asthma hospital admission and emergency department (ED) attendance rates were compared between countries using Poisson regression models, adjusted for age and sex. Results Hospital admission rates for asthma per 1000 child-years varied eight-fold across jurisdictions. Admission rates were 3.5 times higher when admissions with asthma recorded as any diagnosis were considered, compared with admissions with asthma as the primary diagnosis. Iceland had the lowest asthma admission rates; however, when ED attendance rates were considered, Sweden had the lowest rate of asthma hospital contacts. Conclusions The large variations in childhood hospital admission rates for asthma based on the whole child population reflect differing definitions, admission thresholds and underlying disease prevalence rather than primary care quality. Asthma hospital admissions among children diagnosed with asthma is a more meaningful indicator for inter-country comparisons of primary care quality.


BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e026405 ◽  
Author(s):  
Andrew Wilson ◽  
Richard Baker ◽  
John Bankart ◽  
Jay Banerjee ◽  
Ran Bhamra ◽  
...  

AimTo examine system characteristics associated with variations in unplanned admission rates in those aged 85+.DesignMixed methods.SettingPrimary care trusts in England were ranked according to changes in admission rates for people aged 85+ between 2007 and 2009, and study sites selected from each end of the distribution: three ‘improving’ sites where rates had declined by more than 4% and three ‘deteriorating’ sites where rates had increased by more than 20%. Each site comprised an acute hospital trust, its linked primary care trust/clinical commissioning group, the provider of community health services and adult social care.ParticipantsA total of 142 representatives from these organisations were interviewed to understand how policies had been developed and implemented. McKinsey’s 7S framework was used as a structure for investigation and analysis.ResultsIn general, improving sites provided more evidence of comprehensive system focused strategies backed by strong leadership, enabling the development and implementation of policies and procedures to avoid unnecessary admissions of older people. In these sites, primary and intermediate care services appeared more comprehensive and better integrated with other parts of the system, and policies in emergency departments were more focused on providing alternatives to admission.ConclusionsHealth and social care communities which have attenuated admissions of people aged 85+ prioritised developing a shared vision and strategy, with sustained implementation of a suite of interventions.


BMJ ◽  
1999 ◽  
Vol 319 (7202) ◽  
pp. 67-68 ◽  
Author(s):  
R. Jankowski

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Sanny Kappen ◽  
Lisa Koops ◽  
Verena Jürgens ◽  
Michael H. Freitag ◽  
Marco H. Blanker ◽  
...  

Abstract Background There is wide variation in clinical practice for the early detection of prostate cancer, not least because of the ongoing debate about the benefits of prostate-specific antigen (PSA) testing. In this study, we aimed to assess the approaches, attitudes, and knowledge of general practitioners (GPs) regarding PSA testing in primary care in the Netherlands, particularly regarding recommendations for prostate cancer. Methods Questionnaire surveys were sent to 179 GPs in the north-east of the Netherlands, of which 65 (36%) were completed and returned. We also surveyed 23 GPs attending a postgraduate train-the-trainer day (100%). In addition to demographic data and practice characteristics, the 31-item questionnaire covered the attitudes, clinical practice, adherence to PSA screening recommendations, and knowledge concerning the recommendations for prostate cancer early detection. Statistical analysis was limited to the descriptive level. Results Most GPs (95%; n = 82) stated that they had at least read the Dutch GP guideline, but just half (50%; n = 43) also stated that they knew the content. Almost half (46%; n = 39) stated they would offer detailed counseling before ordering a PSA test to an asymptomatic man requesting a test. Overall, prostate cancer screening was reported to be of minor importance compared to other types of cancer screening. Conclusions Clinical PSA testing in primary care in this region of the Netherlands seems generally to be consistent with the relevant guideline for Dutch GPs that is restrictive to PSA testing. The next step will be to further evaluate the effects of the several PSA testing strategies.


2002 ◽  
Vol 8 (1) ◽  
pp. 83 ◽  
Author(s):  
Rick Hayes

It would be a brave health promotion coordinator who would suggest to Primary Care Partnership health promotion sub-committee members that just providing "information" to "people who are problems" is a "best-practice" approach (Legge et aI., 1996). One, and only one, of the many reasons for the change has been the creation and dissemination of the Men's Health Promotion Strategic Framework (Hayes, 1999). This framework was developed through a project funded by the Victorian Health Promotion Foundation and commissioned by the North East Health Promotion Centre (NEHPC), Melbourne.


2016 ◽  
Vol 20 (4) ◽  
pp. 464-472 ◽  
Author(s):  
Lawrence Achilles Nnyanzi

The aim of this study was to explore the reactions of children aged 10–11 years towards being weighed and measured and subsequently told their correct weight as part of the National Child Measurement Programme (NCMP). The study was undertaken in primary schools in a Primary Care Trust (PCT) in the North East of England, UK. One-to-one semi-structured interviews were conducted post-NCMP measurement (and the feedback) with a sample of 21 children, aged 10–11 years, conveniently sampled from the primary schools in the PCT. Findings from the study indicate that the NCMP, especially the weight feedback letter caused annoyance, panic and worry among children who were indicated to have weight problems and oversensitised all children about weight issues, regardless of their weight category. The NCMP is a potentially useful ‘wake-up call’ to the fact that something needs to be done for children identified to be overweight or obese but needs to be delivered with a sensitivity to the impact of the news on the child.


Author(s):  
Chadd K. Kraus

Commonly defined as having greater than four emergency department (ED) visits in a year, patients who are frequent users of the ED make up an estimated 3.5% to 10% of all ED visits and have been reported to account for nearly a third of all ED use. Frequent ED users have higher mortality, higher hospital admission rates, and higher use of all health care services, both specialty and primary care, compared to other patients using the ED. These patients should have the autonomy to access ED evaluation and care if he or she believes he or she has a medical emergency. This principle has been codified into both federal and many state laws protecting the “prudent layperson standard.” These patients should not be coerced to not seek ED care if the person believes he or she has an emergent condition.


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