Page 116 - H:\Annual Report\

Improvements
When a child has
an asthma attack
• Utilised a co-design methodology working with
there is already a parents to identify the optimal solutions and define a
high degree of stress
new pathway
placed on parents
and carers, and it is • Reviewed and streamlined the pathway so that it best
the responsibility of suited the needs of the children and families.
the hospital staff to • Systematically reviewed medical research with
ensure the journey is nurses, doctors, and parents who were involved in
as comfortable and voting about issues with the pathway.
successful as it could
• Incorporated a change in the steroid we use (from
possibly be, and
prednisolone to dexamethasone) – resulting in
discharge is achieved
reduced side effects and reduced frequency of
as soon as possible.
dosing from three to one per day.
• Reduced costs of medication by 90%
• Reduced frequency of exposure to X-rays from 30%
of asthmatic children to 8%.

Reasons for Change This innovative improvement won a national award for
innovation in Pharmacy and the revised pathway is
Hospital admission rates for childhood asthma are being adopted by many other trusts across the UK.
consistently amongst the highest in the UK. There is a
feeling that children in Alder Hey were receiving more Future Plans
treatments than are needed and this was increasing
length of stay. • Complete a follow up audit and seek further
opportunity for improvement
The pathway was plotted and was found to have:
• Publish these findings in a medical journal
• Non-uniformity of care
B. Family and Friends Test
• Some aspects that did not reflect recent best practice
evidence from clinical trials
We have gathered information from children and
• Stress amongst junior doctors and nurses. families through the family and friends test (FFT), a
national tool which provides consistent information that
Alder Hey adopted an inclusive partnership approach is comparable to other organisations and is published
to seeking to make improvements to this pathway. This externally on both NHS England and NHS Choices
included co-designing the revised pathway with staff websites. In addition we have added our own bespoke
and the parent of three boys suffering from asthma. survey questions and the table below provides a
summary of the responses.
The parent was an equal partner in voting about
each recommendation and played a crucial role in
making change. This including teaching the parent
about evidence based medicine and what results
of randomised trials mean, to enable them to make
informed choices.

We also informally spoke with parents of younger
children before the pathway was developed to identify
outcomes of importance and also to agree on the areas
of most interest within the guideline.

Alder Hey Children’s NHS Foundation Trust 116 Annual Report & Accounts 2017/18