Jawad Sarah, Buckingham Anna, Richardson Charlotte, Molloy Aoife, Owolabi Bola, Inada-Kim Matt
Department of Infection Sciences, King's College Hospital, Denmark Hill, London SE5 9RS, UK.
NHS England, Wellington House, London SE1 8UG, UK.
Antibiotics (Basel). 2023 Apr 27;12(5):819. doi: 10.3390/antibiotics12050819.
Patients with acute respiratory infections (ARI)-including those with upper and lower respiratory infections from both bacterial and viral pathogens-are one of the most common reasons for acute deterioration, with large numbers of potentially avoidable hospital admissions. The acute respiratory infection hubs model was developed to improve healthcare access and quality of care for these patients. This article outlines the implementation of this model and its potential impacts in a number of areas. Firstly, by improving healthcare access for patients with respiratory infections by increasing the capacity for assessment in community and non-emergency department settings and also by providing flexible response to surges in demand and reducing primary and secondary care demand. Secondly, by optimising infection management (including the use of point-of-care diagnostics and standardised best practise guidance to improve appropriate antimicrobial usage) and reducing nosocomial transmission by cohorting those with suspected ARI away from those with non-infective presentations. Thirdly, by addressing healthcare inequalities; in areas of greatest deprivation, acute respiratory infection is strongly linked with increased emergency department attendance. Fourthly, by reducing the National Health Service's (NHS) carbon footprint. Finally, by providing a wonderful opportunity to gather community infection management data to enable large-scale evaluation and research.
患有急性呼吸道感染(ARI)的患者——包括那些由细菌和病毒病原体引起的上、下呼吸道感染患者——是急性病情恶化的最常见原因之一,会导致大量本可避免的住院情况。急性呼吸道感染中心模式旨在改善这些患者获得医疗服务的机会和医疗质量。本文概述了该模式的实施情况及其在多个领域的潜在影响。首先,通过增加社区和非急诊科环境中的评估能力,改善呼吸道感染患者获得医疗服务的机会,还通过灵活应对需求激增并减少初级和二级医疗需求。其次,通过优化感染管理(包括使用即时诊断和标准化最佳实践指南来改善抗菌药物的合理使用),并通过将疑似ARI患者与非感染性症状患者分群,减少医院内传播。第三,通过解决医疗不平等问题;在最贫困地区,急性呼吸道感染与急诊科就诊人数增加密切相关。第四,通过减少国民医疗服务体系(NHS)的碳足迹。最后,通过提供一个绝佳机会来收集社区感染管理数据,以便进行大规模评估和研究。