Professor Sarah Purdy reviews the 2013-14 work of the Avoiding Hospital Admissions Health Integration Team (ITHAcA HIT).
It has been a productive year for the Integration to Avoid Hospital Admissions (ITHAcA) HIT. We have focused on our aims to reduce the complexity in the urgent care system and to develop the capacity to use data in evaluating changes and optimising the productivity of existing and new interventions. ITHAcA has four priority themes: using data to inform commissioning; chronic obstructive disease (COPD); dementia and childhood asthma.
Our programme of work has begun with a focus on COPD, with an application to the NIHR Health Services and Delivery Research programme to evaluate admission and discharge care bundles for people with COPD in collaboration with the British Thoracic Society: we are waiting for final confirmation of funding. We have also recently completed a locally funded study to explore the feasibility of using a systems dynamics modelling approach to understand and reconfigure services available for patients with COPD. Local funding has also been obtained to look at a systematic review of case management in heart failure. Other applications recently submitted include a Programme Development Grant on managing uncertainty to reduce emergency bed days for older people and a small grant to examine the feasibility of applying a systems dynamics approach to investigating dementia services.
We are also focusing on the development of the HIT as an information repository, through the creation of a website offering information about avoidable admissions. From our recent circulation of documentation, a request was made for a virtual wards meeting, which was attended by six senior Bristol, North Somerset and South Gloucestershire NHS staff. The aim was to review the evidence and think about how to develop this initiative locally. From this discussion a request was made for a systematic review of virtual wards, which is being prepared for submission to CLARHC West.
Future plans include exploring evaluating the use of voluntary sector services to reduce admissions, and working in partnership with clinical colleagues to support an evaluation of an existing discharge service aimed at reducing future hospital admissions.