Using quality improvement to tackle the triple aim for children and young people with asthma: improving outcomes, experience and costs

Q4 Medicine
M. Aurelio, Rita Araujo, Janeke Zoetmann, J. Moody, Amar J. Shah
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引用次数: 0

Abstract

Asthma in children and young people represents a substantial burden to the healthcare system, with these patients requiring frequent emergency care and having poorer health outcomes, leading to high system costs and poor patient experiences. This study used quality improvement methodology to achieve the triple aim of improved outcomes, better experience and reduced costs for those aged 0–16 years with asthma in north east London. A multidisciplinary project team used quality improvement methods to implement and assess two interventions: a community high-risk asthma clinic and educational asthma-friendly school groups, both of which were delivered by a specialist asthma nurse. Population-level outcomes included asthma control test scores, accident and emergency department admissions and costs. Intervention-specific outcomes included number of clinic consultations delivered, did-not-attend rates and participant confidence ratings following the school sessions. Accident and emergency admissions for asthma reduced by 52%, with a 50% reduction in average monthly acute care costs. Asthma control test scores improved significantly, from an average of 18.56 to 22.34 out of a maximum score of 25 (P=0.000) following the interventions. Participants in the asthma-friendly school groups reported increased confidence in both day-to-day and emergency asthma management at the end of their sessions. Having dedicated specialist asthma nurse input in the community and using school-based interventions can help to improve asthma care for children and young people, reducing the burden of frequent accident and emergency department admissions. Using quality improvement methods in pursuit of triple aim outcomes can help teams to work towards a shared goal.
使用质量改进来解决患有哮喘的儿童和青少年的三重目标:改善结果、经验和成本
儿童和年轻人的哮喘是医疗保健系统的重大负担,这些患者需要频繁的紧急护理,健康结果较差,导致系统成本高,患者体验差。本研究采用质量改进方法,为伦敦东北部0-16岁哮喘患者实现改善结果、改善体验和降低成本的三重目标。一个多学科项目小组使用质量改进方法来实施和评估两项干预措施:社区高危哮喘诊所和教育哮喘友好学校小组,两者都由哮喘专科护士提供。人群水平的结果包括哮喘控制测试分数、急诊科入院率和费用。具体的干预结果包括提供的诊所咨询数量,未出席率和参与者在学校课程后的信心评级。因哮喘而入院的事故和急诊减少了52%,平均每月急症护理费用减少了50%。干预后,哮喘控制测试得分显著提高,从平均18.56分提高到22.34分(最高25分)(P=0.000)。哮喘友好学校小组的参与者报告说,在会议结束时,他们对日常和紧急哮喘管理的信心都有所增加。在社区中投入专门的哮喘专科护士和使用基于学校的干预措施可以帮助改善儿童和年轻人的哮喘护理,减少频繁的事故和急诊入院的负担。使用质量改进方法来追求三重目标的结果可以帮助团队朝着共同的目标努力。
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来源期刊
CiteScore
1.10
自引率
0.00%
发文量
95
期刊介绍: British Journal of Healthcare Management (BJHCM) is the independent monthly journal which is essential reading for all health service managers, policymakers, influencers and commentators. Launched in 1995, BJHCM mixes peer-reviewed management articles with interviews, analysis and comment to bring you a sharp, topical and valuable insight into what"s happening in and around the NHS. To reflect the way that the NHS is changing, the journal has recently received a major face-lift and several new features now appear alongside BJHCM"s excellent state-of-the-art review articles and celebrated columnists.
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