Identifying and prioritising future interventions with stakeholders to improve paediatric urgent care pathways in Scotland, UK: a mixed-methods study
Objectives To identify and prioritise interventions, from the perspectives of parents and health professionals, which may be alternatives to current unscheduled paediatric urgent care pathways.Design FLAMINGO (FLow of AdMissions in chIldren and youNG peOple) is a sequential mixed-methods study, with...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-10-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/10/e074141.full |
| _version_ | 1827122228747042816 |
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| author | Lorna Aucott Pat Hoddinott Philip Wilson Stephen Turner Richard G Kyle Emma King Smita Dick Emma France Cari Malcolm Simita Kumar |
| author_facet | Lorna Aucott Pat Hoddinott Philip Wilson Stephen Turner Richard G Kyle Emma King Smita Dick Emma France Cari Malcolm Simita Kumar |
| author_sort | Lorna Aucott |
| collection | DOAJ |
| description | Objectives To identify and prioritise interventions, from the perspectives of parents and health professionals, which may be alternatives to current unscheduled paediatric urgent care pathways.Design FLAMINGO (FLow of AdMissions in chIldren and youNG peOple) is a sequential mixed-methods study, with public and patient involvement (PPI) throughout. Data linkage for urgent admissions and three referral sources: emergency department, out of hours service and general practice, was followed by qualitative interviews with parents and professionals. Findings were presented and discussed at a stakeholder intervention prioritisation event.Setting National Health Service in Scotland, UK.Participants Quantitative data: children with urgent medical admission to hospital from 2015 to 2017. Qualitative interviews: parents and health professionals with experiences of urgent short stay hospital admissions of children. PPI engagement was conducted with nine parent–toddler groups and a university-based PPI advisory group. Stakeholder event: parents, health professionals and representatives from Scottish Government, academia, charities and PPI attended.Results Data for 171 039 admissions which included 92 229 short stay admissions were analysed and 48 health professionals and 21 parents were interviewed. The stakeholder event included 7 parents, 12 health professionals and 28 other stakeholders. Analysis and synthesis of all data identified seven interventions which were prioritised at the stakeholder event: (1) addressing gaps in acute paediatric skills of health professionals working in community settings; (2) assessment and observation of acutely unwell children in community settings; (3) creation of holistic children’s ‘hubs’; (4) adoption of ‘hospital at home’ models; and three specialised care pathways for subgroups of children; (5) convulsions; (6) being aged <2 years old; and (7) wheeze/bronchiolitis. Stakeholders prioritised interventions 1, 2 and 3; these could be combined into a whole population intervention. Barriers to progressing these include resources, staffing and rurality.Conclusions Health professionals and families want future interventions that are patient-centred, community-based and aligned to outcomes that matter to them. |
| first_indexed | 2024-03-11T13:43:40Z |
| format | Article |
| id | doaj.art-d2f1494a05484ff1ab8b495257c62b5c |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2025-03-20T14:05:42Z |
| publishDate | 2023-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-d2f1494a05484ff1ab8b495257c62b5c2024-09-11T07:00:09ZengBMJ Publishing GroupBMJ Open2044-60552023-10-01131010.1136/bmjopen-2023-074141Identifying and prioritising future interventions with stakeholders to improve paediatric urgent care pathways in Scotland, UK: a mixed-methods studyLorna Aucott0Pat Hoddinott1Philip Wilson2Stephen Turner3Richard G Kyle4Emma King5Smita Dick6Emma France7Cari Malcolm8Simita Kumar9Centre for Randomised Healthcare Trials, University of Aberdeen, Aberdeen, UK7 Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Stirling, UKCentre for Rural Health, University of Aberdeen, Inverness, UKWomen and Children Division NHS Grampian, Aberdeen, UKAcademy of Nursing, Department of Health and Care Professions, Faculty of Health and Life Sciences, University of Exeter, Exeter, UKUniversity Hospitals Plymouth NHS Trust, Plymouth, UKChild Health, University of Aberdeen, Aberdeen, UKNursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UKSchool of Health Sciences, University of Dundee, Dundee, UKScreening and Immunisation, Public Health Scotland, Edinburgh, UKObjectives To identify and prioritise interventions, from the perspectives of parents and health professionals, which may be alternatives to current unscheduled paediatric urgent care pathways.Design FLAMINGO (FLow of AdMissions in chIldren and youNG peOple) is a sequential mixed-methods study, with public and patient involvement (PPI) throughout. Data linkage for urgent admissions and three referral sources: emergency department, out of hours service and general practice, was followed by qualitative interviews with parents and professionals. Findings were presented and discussed at a stakeholder intervention prioritisation event.Setting National Health Service in Scotland, UK.Participants Quantitative data: children with urgent medical admission to hospital from 2015 to 2017. Qualitative interviews: parents and health professionals with experiences of urgent short stay hospital admissions of children. PPI engagement was conducted with nine parent–toddler groups and a university-based PPI advisory group. Stakeholder event: parents, health professionals and representatives from Scottish Government, academia, charities and PPI attended.Results Data for 171 039 admissions which included 92 229 short stay admissions were analysed and 48 health professionals and 21 parents were interviewed. The stakeholder event included 7 parents, 12 health professionals and 28 other stakeholders. Analysis and synthesis of all data identified seven interventions which were prioritised at the stakeholder event: (1) addressing gaps in acute paediatric skills of health professionals working in community settings; (2) assessment and observation of acutely unwell children in community settings; (3) creation of holistic children’s ‘hubs’; (4) adoption of ‘hospital at home’ models; and three specialised care pathways for subgroups of children; (5) convulsions; (6) being aged <2 years old; and (7) wheeze/bronchiolitis. Stakeholders prioritised interventions 1, 2 and 3; these could be combined into a whole population intervention. Barriers to progressing these include resources, staffing and rurality.Conclusions Health professionals and families want future interventions that are patient-centred, community-based and aligned to outcomes that matter to them.https://bmjopen.bmj.com/content/13/10/e074141.full |
| spellingShingle | Lorna Aucott Pat Hoddinott Philip Wilson Stephen Turner Richard G Kyle Emma King Smita Dick Emma France Cari Malcolm Simita Kumar Identifying and prioritising future interventions with stakeholders to improve paediatric urgent care pathways in Scotland, UK: a mixed-methods study BMJ Open |
| title | Identifying and prioritising future interventions with stakeholders to improve paediatric urgent care pathways in Scotland, UK: a mixed-methods study |
| title_full | Identifying and prioritising future interventions with stakeholders to improve paediatric urgent care pathways in Scotland, UK: a mixed-methods study |
| title_fullStr | Identifying and prioritising future interventions with stakeholders to improve paediatric urgent care pathways in Scotland, UK: a mixed-methods study |
| title_full_unstemmed | Identifying and prioritising future interventions with stakeholders to improve paediatric urgent care pathways in Scotland, UK: a mixed-methods study |
| title_short | Identifying and prioritising future interventions with stakeholders to improve paediatric urgent care pathways in Scotland, UK: a mixed-methods study |
| title_sort | identifying and prioritising future interventions with stakeholders to improve paediatric urgent care pathways in scotland uk a mixed methods study |
| url | https://bmjopen.bmj.com/content/13/10/e074141.full |
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