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Asthma in emergency care

The Oxford AHSN Respiratory Clinical Network will use and measure Royal College of Physicians identified markers of risk for mortality and poor asthma control as surrogates of good and poor asthma care. This is to understand how primary care is performing within the Oxford AHSN region and then identify where to target intervention to improve this care.

Patients with asthma will often present to hospital emergency departments (ED) or NHS urgent care centres. They are often not admitted to hospital but are treated and discharged. The NRAD report highlight the fact that 24% of patients who died from asthma were in these ‘pre-hospital’ settings. 10% of asthmatics that died had been to ED in the month before death and 28% had attended within a year.

There is an urgent need to assess the provision of asthma care in EDs in order to improve care and reduce morbidity and mortality through the provision of effective care pathways.

Scope

This project will be across the whole Oxford AHSN region. It will be carried out within NHS urgent care centres and EDs of all the acute trusts:

  • Oxford University Hospitals
  • Buckinghamshire Healthcare
  • Frimley Health
  • Great Western Hospitals
  • Milton Keynes University Hospital
  • Royal Berkshire.

The project will assess current asthma care provision and revise the clinical processes in the EDs.

Outcomes

  • Identify current rates of attendance for asthma to EDs
  • Identify current standards of care for patients presenting to ED with asthma
  • Produce a unified set of standards of care for implementation agreed with all stakeholders across the Oxford AHSN region so that each patient presenting to ED will receive a clear treatment and follow up plan
  • Reduction in re-attendance at EDs for asthma by 20%
  • Reduction of asthma mortality in pre-hospital setting
  • Increase in attendance to specialist follow-up clinics by 30%
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