Triumph of hope over experience: learning from interventions to reduce avoidable hospital admissions identified through an Academic Health and Social Care Network
<p>Abstract</p> <p>Background</p> <p>Internationally health services are facing increasing demands due to new and more expensive health technologies and treatments, coupled with the needs of an ageing population. Reducing avoidable use of expensive secondary care servic...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2012-06-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | http://www.biomedcentral.com/1472-6963/12/153 |
| _version_ | 1818484008178155520 |
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| author | Woodhams Victoria de Lusignan Simon Mughal Shakeel Head Graham Debar Safia Desombre Terry Hilton Sean Al Sharifi Houda |
| author_facet | Woodhams Victoria de Lusignan Simon Mughal Shakeel Head Graham Debar Safia Desombre Terry Hilton Sean Al Sharifi Houda |
| author_sort | Woodhams Victoria |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Internationally health services are facing increasing demands due to new and more expensive health technologies and treatments, coupled with the needs of an ageing population. Reducing avoidable use of expensive secondary care services, especially high cost admissions where no procedure is carried out, has become a focus for the commissioners of healthcare.</p> <p>Method</p> <p>We set out to identify, evaluate and share learning about interventions to reduce avoidable hospital admission across a regional Academic Health and Social Care Network (AHSN). We conducted a service evaluation identifying initiatives that had taken place across the AHSN. This comprised a literature review, case studies, and two workshops.</p> <p>Results</p> <p>We identified three types of intervention: pre-hospital; within the emergency department (ED); and post-admission evaluation of appropriateness. Pre-hospital interventions included the use of predictive modelling tools (PARR – Patients at risk of readmission and ACG – Adjusted Clinical Groups) sometimes supported by community matrons or virtual wards. GP-advisers and outreach nurses were employed within the ED. The principal post-hoc interventions were the audit of records in primary care or the application of the Appropriateness Evaluation Protocol (AEP) within the admission ward. Overall there was a shortage of independent evaluation and limited evidence that each intervention had an impact on rates of admission.</p> <p>Conclusions</p> <p>Despite the frequency and cost of emergency admission there has been little independent evaluation of interventions to reduce avoidable admission. Commissioners of healthcare should consider interventions at all stages of the admission pathway, including regular audit, to ensure admission thresholds don’t change.</p> |
| first_indexed | 2024-12-10T15:49:47Z |
| format | Article |
| id | doaj.art-6400854f515546eb9590dc5ff74245e5 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-10T15:49:47Z |
| publishDate | 2012-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-6400854f515546eb9590dc5ff74245e52022-12-22T01:42:50ZengBMCBMC Health Services Research1472-69632012-06-0112115310.1186/1472-6963-12-153Triumph of hope over experience: learning from interventions to reduce avoidable hospital admissions identified through an Academic Health and Social Care NetworkWoodhams Victoriade Lusignan SimonMughal ShakeelHead GrahamDebar SafiaDesombre TerryHilton SeanAl Sharifi Houda<p>Abstract</p> <p>Background</p> <p>Internationally health services are facing increasing demands due to new and more expensive health technologies and treatments, coupled with the needs of an ageing population. Reducing avoidable use of expensive secondary care services, especially high cost admissions where no procedure is carried out, has become a focus for the commissioners of healthcare.</p> <p>Method</p> <p>We set out to identify, evaluate and share learning about interventions to reduce avoidable hospital admission across a regional Academic Health and Social Care Network (AHSN). We conducted a service evaluation identifying initiatives that had taken place across the AHSN. This comprised a literature review, case studies, and two workshops.</p> <p>Results</p> <p>We identified three types of intervention: pre-hospital; within the emergency department (ED); and post-admission evaluation of appropriateness. Pre-hospital interventions included the use of predictive modelling tools (PARR – Patients at risk of readmission and ACG – Adjusted Clinical Groups) sometimes supported by community matrons or virtual wards. GP-advisers and outreach nurses were employed within the ED. The principal post-hoc interventions were the audit of records in primary care or the application of the Appropriateness Evaluation Protocol (AEP) within the admission ward. Overall there was a shortage of independent evaluation and limited evidence that each intervention had an impact on rates of admission.</p> <p>Conclusions</p> <p>Despite the frequency and cost of emergency admission there has been little independent evaluation of interventions to reduce avoidable admission. Commissioners of healthcare should consider interventions at all stages of the admission pathway, including regular audit, to ensure admission thresholds don’t change.</p>http://www.biomedcentral.com/1472-6963/12/153(MeSH): HospitalizationHealth Services MisuseOutcome and Process Assessment (Health Care)Home Care ServicesHospital based [economics*organisation and administration] |
| spellingShingle | Woodhams Victoria de Lusignan Simon Mughal Shakeel Head Graham Debar Safia Desombre Terry Hilton Sean Al Sharifi Houda Triumph of hope over experience: learning from interventions to reduce avoidable hospital admissions identified through an Academic Health and Social Care Network BMC Health Services Research (MeSH): Hospitalization Health Services Misuse Outcome and Process Assessment (Health Care) Home Care Services Hospital based [economics *organisation and administration] |
| title | Triumph of hope over experience: learning from interventions to reduce avoidable hospital admissions identified through an Academic Health and Social Care Network |
| title_full | Triumph of hope over experience: learning from interventions to reduce avoidable hospital admissions identified through an Academic Health and Social Care Network |
| title_fullStr | Triumph of hope over experience: learning from interventions to reduce avoidable hospital admissions identified through an Academic Health and Social Care Network |
| title_full_unstemmed | Triumph of hope over experience: learning from interventions to reduce avoidable hospital admissions identified through an Academic Health and Social Care Network |
| title_short | Triumph of hope over experience: learning from interventions to reduce avoidable hospital admissions identified through an Academic Health and Social Care Network |
| title_sort | triumph of hope over experience learning from interventions to reduce avoidable hospital admissions identified through an academic health and social care network |
| topic | (MeSH): Hospitalization Health Services Misuse Outcome and Process Assessment (Health Care) Home Care Services Hospital based [economics *organisation and administration] |
| url | http://www.biomedcentral.com/1472-6963/12/153 |
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