Partners in paediatrics

Started: 2010
Region: West Midlands
Geography: Mixed

Background / Motivation

The hospital identified that the number of children with acute health problems admitted to paediatric wards was about twice the admission rate of other hospitals in similar communities. There were 10 common conditions where children referred into the hospital by a GP were discharged within four hours without active clinical intervention

Aims

Educational aims to ‘upskill’ primary care clinicians:

1. To increase the competence and confidence of GPs and nurses in the clinical management of children with acute health problems

2. To reverse the year-on-year rise in inappropriate referrals to the Paediatric Assessment Unit by primary care clinicians

3. To improve the patient experience, particularly providing services closer to patient homes

Target patient groups

Children

The service model

10 master-class sessions, run by paediatric consultants were held in Spring/Summer 2011 for primary care clinicians

Approximately 250 clinicians took part, including 114 GPs (40% of the local GP cohort), 79 nurses and participants from other clinical backgrounds (student doctors, clinical educators, community midwives)

Master-class topics:

Respiratory problems
Failure to thrive
Gastroenteritis
Abdominal pain
Constipation
Fever management/febrile child
Fits, faints, funny turns
Rashes and skin problems
Mixture of acute admissions
Paediatric pre-referral guidelines and urgent care referral guidelines were produced and made readily available to all of primary care.

Staffing

GPs & Practice Nurses

Evaluation

Very positive overall response to the programme – most GPs that took part felt that the master-classes had increased their ability and confidence in the clinical care of acutely unwell children.

Participants welcomed the teaching and the locally developed guidelines

After 18 months, GP and nurse participants indicated that they felt more competent and confident in the clinical management of children with acute health problems; that they were retaining more patient care within primary care; and that they were referring more appropriately; they also felt better able to advise/support parents/carers.

Specific changes in practice that were identified included the use of pulse oximetry for respiratory paediatric cases