Avoidable admissions

General avoidable admissions projects

• A tool to examine where an admission has been avoided. Funded by APCRC, led by Helen Baxter in collaboration with Bristol and South Gloucestershire CCGs
• Exploring the role of first aid education in supprting people attending urgent care services. Funded by Red Cross, led by Julie Mytton from the Child Injury Prevention HIT

Children’s respiratory conditions

This work stream focuses on the ongoing work to improve the management of children’s respiratory conditions in the community, and to increase the understanding of reasons for unplanned admissions and attendances at the emergency department.

• Work stream lead: Sarah Purdy
• Other HIT members: Melanie Chalder, Alyson Huntley, Leah Bowen

Objective

• To develop a detailed knowledge of the flow of children with respiratory conditions through the urgent care system, and the impact of changes in flow on the system

Projects

• Clinician decision-making for non-life threatening respiratory illness in children under five years. Funded by the National Institute for Health Research School for Primary Care. PhD project for Leah Bowen, supervised by Sarah Purdy and Alison Heawood
• A study using modelling techniques to understand the use of unscheduled secondary care services by children with asthma, funded by Avon Primary Care Research Collaborative (APCRC), led by Melanie Chalder

Chronic obstructive pulmonary disease (COPD)

This work stream aims to build on existing initiatives to provide new evidence to reduce local admissions which are currently 25 per cent above national average.

• Work stream lead: Sarah Purdy
• Other HIT members: James Calvert, Jonathan Benger, Melanie Chalder

Objectives

• To develop an increased understanding of the levels of severity and risk at presentation
• To create an agreed strategy for reducing and managing acute admissions across Bath, North Somerset and South Gloucestershire
• To reduce avoidable admissions as a result of evidence-based interventions including smoking cessation
• To strengthen pulmonary rehabilitation and intensive patient education on self-management and follow-up
• To reduce re-admissions due to systemisation of acute care episodes to reduce variability and increase standards of practice
• To develop, pilot and evaluate interventions based on integration of care within and between primary and secondary care
• To develop systems for earlier diagnosis to reduce lifetime care costs and improved patient outcomes

Projects

• An exploratory study using system dynamics to understand the use of unscheduled secondary care services by adults with chronic respiratory disease. Funded by APCRC. Led by Melanie Chalder
• An evaluation of the effectiveness of ‘care bundles’ as a means of improving hospital care and reducing hospital re-admission for patients with chronic obstructive pulmonary disease (COPD). In collaboration with the British Thoracic Society. Funded by the National Institute for Health Research, Health Service and Delivery Research. Led by Sarah Purdy

Dementia

This work stream focuses on patients with dementia and intercurrent physical illness. It looks at appropriate interventions to reduce avoidable unplanned admissions and re-admissions and considers the need to take account of the impact on informal carers, and social and community health care providers. In Bristol and South Gloucestershire, the incidence of dementia diagnoses is set to rise significantly over the next 20 years. Success in this area is key to a long term admissions reduction strategy.

• Work stream lead: Sarah Purdy
• Other HIT members: Melanie Chalder

Objectives

• To increase knowledge about triggers and causes of admission leading to development, piloting and evaluation of interventions across health, social care and neighbourhood development
• To improve the appropriateness of admissions for people with dementia and intercurrent illness
• To reduce the length of stay in bedded settings for people with dementia and intercurrent illness
• To reduce re-admissions for people with dementia and intercurrent illness

Projects

• Understanding the causes and reasons behind avoidable hospital admissions in people living with dementia: bringing together national and local data. Funded by the National Institute for Health Research Applied Research Collaboration West (ARC West) and in collaboration with the Dementia HIT. Led by Sarah Purdy
• Developing a targeted post diagnostic intervention for people affected by dementia and their families. Funded by ARC West and in association with the Dementia HIT. Led by Sarah Purdy