Janie,
Children with neurological disability are vulnerable to developing acute-on-chronic respiratory problems, usually infective in nature. Hospital admissions for treatments are a frequent occurrence. Provision of care on an inpatient basis carries considerable human costs for children and families and can be expensive to administer.
Families and children told us that:
- They were anxious and stressed during times of hospital admission
- They didn’t want to be separated from each other, their wider family and friends
- They didn’t like taking time off school and work
We have subsequently remodeled our service to facilitate greater home support. Specialist nurses and respiratory physiotherapists now visit and review patients at home more frequently in order to identify and manage recurrent infections early, which helps reduce hospital admissions.
Paediatric Respiratory Physiotherapy and Nursing staff collected data on 11 patients with significant respiratory vulnerability and measured the number of hospital admissions, length of stay, hospital bed days, courses of oral antibiotics prescribed, frequency of home visits and frequency of attendance at outpatient clinics before and after we introduced changes.
The table below shows the data for 2015-2016 before we made changes, and for 2016-2017 after we made the changes:
The data shows that remodelling our service to facilitate greater home support for a specific group of vulnerable patients has been highly effective. This has partly been achieved because of the extended roles of specialist staff who can prescribe medicines.
The families agree that this remodelling is a great success; telling us:
“Really flexible, offered good advice, had a very positive experience”
“This has been the longest ever my son hasn’t had to be in hospital since home visits started”
“Has made it so much easier for me having everyone come to the house to see my son”
“It’s been a lot easier not having to take so much time off work as team have worked with our circumstances which has been a huge help”
“I prefer to keep my son at home and try to prevent a hospital stay. Felt supported with the home visits, which has allowed my son to be seen in his own environment rather than taking him to hospital where they don’t always get a clear picture of how he has been, either he perks up, or acts up being at the hospital.”
If you have an experience of the Physiotherapy Service you would like to share, please speak to a member of staff, respond on Care Opinion, or visit the “Your Feedback” Section of the NHS Lanarkshire website to see the other ways to get in touch www.nhslanarkshire.org.uk
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Posted by Janie Thomson, Head of Profession, Physiotherapy Services, University Hospital Hairmyres, NHS Lanarkshire, on
About: NHS Lanarkshire
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