Emergency care patient driven solutions for severe asthma

Journal article


Newell, K, Corrigan, C, Punshon, G and Leary, A (2017). Emergency care patient driven solutions for severe asthma. International Journal of Health Care Quality Assurance. 30 (7), pp. 628-637.
AuthorsNewell, K, Corrigan, C, Punshon, G and Leary, A
Abstract

Purpose Patients with severe asthma were choosing not to use the emergency department in extremis and were self-medicating when experiencing severe asthma, putting their lives at risk. This local issue was a reflection of a nationwide situation. The aim of this study was to better understand the reasons for this locally and consider practical solutions in a structured way with users of the service Methodology Systems thinking was used (soft systems methodology) to better understand the problem and examine possible solutions in co-production with people who live with severe asthma. Findings and Practical implications The problem was identified and fully revealed-patients felt vulnerable and fearful of the emergency department. This appeared to be a well-defined problem with possible solutions. Once this tame problem was revealed a possible solution was developed in co-production with patients. The solution was an Asthma Patient Passport (APP) which increased confidence in patient’s ability to communicate their needs in severe distress by facilitating communication of needs and decreased the work patients had to do to achieve care from twelve steps to five steps. The implementation of the APP is currently being evaluated. Value By revisiting systems thinking and identifying problems, a solution was possible. Although methods such as soft systems methodology have limitations when used to in wicked problems, such methods still appear to have merit in tame problems and could be used in these circumstances to fully understand problems and design practical solutions.

KeywordsPublic Health And Health Services; Health Policy & Services; Asthma
Year2017
JournalInternational Journal of Health Care Quality Assurance
Journal citation30 (7), pp. 628-637
PublisherEmerald Group Publishing Ltd.
ISSN0952-6862
Digital Object Identifier (DOI)doi:10.1108/ijhcqa-09-2016-0127
Publication dates
Print14 Aug 2017
Publication process dates
Deposited22 May 2017
Accepted01 Sep 2016
Accepted author manuscript
Permalink -

https://openresearch.lsbu.ac.uk/item/86y3v

  • 5
    total views
  • 30
    total downloads
  • 1
    views this month
  • 1
    downloads this month

Related outputs

The healthcare workforce should be shaped by outcomes, rather than outputs
Leary, A (2019). The healthcare workforce should be shaped by outcomes, rather than outputs. BMJ Opinion.
Staffing the NHS: Why we need to invest in the community workforce
Leary, A (2019). Staffing the NHS: Why we need to invest in the community workforce. in: Martinez, C (ed.) The NHS Winter Crisis Reform. pp. 6
Determining acute nurse staffing, a hermeneutic review of an evolving science.
Leary, A and Punshon, G (2019). Determining acute nurse staffing, a hermeneutic review of an evolving science. BMJ Open. 9 (3).
Nursing pay by gender distribution in the UK- does the Glass Escalator still exist?
Leary, A, Punshon, G, MacLaine, K, Radford, M, Trevatt, P and Shanley, O (2019). Nursing pay by gender distribution in the UK- does the Glass Escalator still exist? International Journal of Nursing Studies.
Uncovering the hidden workload of providing cancer care in the community
Lawler, J., Leary, A., Lydia, L. and Bushe, D. (2019). Uncovering the hidden workload of providing cancer care in the community. Primary Health Care.
An observational study on the rate of reporting of adverse event on healthcare staff in a mental health setting: an application of Poisson Expectation Maximisation analysis on nurse staffing data
Cook, R., Jones, S., Worsley, D., Williams, G., Walker, R., Radford, M. and Leary, A. (2019). An observational study on the rate of reporting of adverse event on healthcare staff in a mental health setting: an application of Poisson Expectation Maximisation analysis on nurse staffing data. Health informatics journal.
Does the Diabetes Specialist Nursing workforce impact the experiences and outcomes of people with diabetes? A hermeneutic review of the evidence
Lawler, J., Trevatt, P., Elliot, C. and Leary, A. (2019). Does the Diabetes Specialist Nursing workforce impact the experiences and outcomes of people with diabetes? A hermeneutic review of the evidence. Human Resources for Health. 17 (65).
Barriers to delivering advanced cancer nursing: A workload analysis of specialist nurse practice linked to the English National Lung Cancer Audit
Stewart, I, Leary, A, Tod, A, Borthwick, D, Khakwani, A, Hubbard, R, Beckett, P and Tata, LJ (2018). Barriers to delivering advanced cancer nursing: A workload analysis of specialist nurse practice linked to the English National Lung Cancer Audit. European Journal of Oncology Nursing. 36, pp. 103-111.
Are working practices of lung cancer nurse specialists associated with variation in peoples’ receipt of anti cancer therapy
Stewart, I, Khakwani, A, Hubbard, R, Beckett, P, Borthwick, D, Tod, A, Leary, A and Tata, LJ (2018). Are working practices of lung cancer nurse specialists associated with variation in peoples’ receipt of anti cancer therapy. Lung Cancer. 123, pp. 160-165.
Modelling the Inflammatory Bowel Disease Specialist Nurse Workforce standards by determination of optimum caseloads in the United Kingdom.
Leary, A, Punshon, G and Mason, I (2018). Modelling the Inflammatory Bowel Disease Specialist Nurse Workforce standards by determination of optimum caseloads in the United Kingdom. Journal of Crohn's and Colitis.
Turning data into useful knowledge to improve patient care
Leary, A (2018). Turning data into useful knowledge to improve patient care. Journal of Nursing Management.
Do lung cancer nurses relieve the burden of lung cancer? An outcomes study
Leary, A (2018). Do lung cancer nurses relieve the burden of lung cancer? An outcomes study. Cancer Services, Data and Outcomes Conference 2018. Manchester 20 - 21 Jun 2018 London South Bank University.
Impact of proactive case management by multiple sclerosis specialist nurses on use of unscheduled care and emergency presentation in multiple sclerosis
Leary, A, Quinn, D and Bowen, A (2015). Impact of proactive case management by multiple sclerosis specialist nurses on use of unscheduled care and emergency presentation in multiple sclerosis. International Journal of MS Care. 17 (4), pp. 159-163.
Crowd medical services in the English Football League: remodelling the team for the 21st century using a realist approach
Leary, A, Kemp, A, Greenwood, P, Hart, N, Agnew, J, Barrett, J and Punshon, G (2017). Crowd medical services in the English Football League: remodelling the team for the 21st century using a realist approach. BMJ Open.
Variation in job titles within the nursing workforce.
Leary, A, Maclaine, K, Trevatt, P, Radford, M and Punshon, G (2017). Variation in job titles within the nursing workforce. Journal of Clinical Nursing.
Developing the next generation of specialist cancer nurses.
Leary, A, Whittaker, AJ and Hill, A (2017). Developing the next generation of specialist cancer nurses. Cancer Nursing Practice. 16 (9), pp. 25-30.
The specialist nursing workforce caring for men with prostate cancer in the UK
Leary, A, Brocksom, J, Endacott, R, Fleure, L, Howdle, F, Masterton, M, O'Connor, A, Swift, A, Trevatt, P and Aslett, P (2015). The specialist nursing workforce caring for men with prostate cancer in the UK. International Journal of Urological Nursing. 10 (1), pp. 5-13.
Which patients are assessed by lung cancer nurse specialists? A national lung cancer audit study of over 128,000 patients across england
Khakwani, A, Hubbard, R, Beckett, P, Borthwick, D, Tod, A, Leary, A, White, J and Tata, LJ (2016). Which patients are assessed by lung cancer nurse specialists? A national lung cancer audit study of over 128,000 patients across england. Lung Cancer. 96, pp. 33-40.
A systematic literature review comparing the psychological care needs of patients with mesothelioma and advanced lung cancer
Ball, H, Moore, S and Leary, A (2016). A systematic literature review comparing the psychological care needs of patients with mesothelioma and advanced lung cancer. European Journal of Oncology Nursing. 25, pp. 62-67.
Nurse staffing levels and outcomes - mining the UK national datasets for insight.
Leary, A, Tomai, B, Swift, A, Woodward, A and Hurst, K (2017). Nurse staffing levels and outcomes - mining the UK national datasets for insight. International Journal of Health Care Quality Assurance. 30 (3), pp. 235-247.
Mining routinely collected acute data to reveal non-linear relationships between nurse staffing levels and outcomes
Leary, A, Cook, R, Jones, S, Smith, S, Maxwell, E, Punshon, G and Radford, M (2016). Mining routinely collected acute data to reveal non-linear relationships between nurse staffing levels and outcomes. BMJ Open. 6 (12).
Safety and service. Reframing the purpose of nursing to decision makers
Leary, A (2017). Safety and service. Reframing the purpose of nursing to decision makers. Journal of Clinical Nursing.
The experiences of specialist nurses working within the uro-oncology multidisciplinary team in the UK
Punshon, G, Endacott, R, Aslett, P, Brocksom, J, Fluere, L, Howdle, F, Masterson, M, O'Connor, A, Swift, A, Trevatt, P and Leary, A (2017). The experiences of specialist nurses working within the uro-oncology multidisciplinary team in the UK. Clinical Nurse Specialist: The Journal for Advanced Nursing Practice.
Advancing Nursing Practice: The Emergence of the Role of Advanced Practice Nurse in Saudi Arabia
Hibbert, D, Aboshaiqah, A, Senko, K, Forestall, D, Harb, A, Yousuf, S, Kelley, P, Brennan, P, Serrant, L and Leary, A (2017). Advancing Nursing Practice: The Emergence of the Role of Advanced Practice Nurse in Saudi Arabia. Annals of Saudi Medicine. 37 (1), pp. 522-528.