Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK
Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, UK.
BMJ Open. 2023 Oct 12;13(10):e074141. doi: 10.1136/bmjopen-2023-074141.
To identify and prioritise interventions, from the perspectives of parents and health professionals, which may be alternatives to current unscheduled paediatric urgent care pathways.
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.
National Health Service in Scotland, UK.
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.
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.
Health professionals and families want future interventions that are patient-centred, community-based and aligned to outcomes that matter to them.
从家长和卫生专业人员的角度确定并优先考虑可能替代当前非计划性儿科紧急护理途径的干预措施。
FLAMINGO（儿童和年轻人入院流程）是一项序贯混合方法研究，整个过程都有公众和患者参与（PPI）。对紧急入院和三个转诊来源（急诊部、非工作时间服务和全科医疗）进行数据链接，然后对有儿童紧急短期住院经历的家长和专业人员进行定性访谈。研究结果在利益相关者干预措施优先级事件中进行了陈述和讨论。
英国苏格兰国民保健系统。
定量数据：2015 年至 2017 年期间因紧急医疗入院的儿童。定性访谈：有儿童紧急短期住院经历的家长和卫生专业人员。与 9 个家长-幼儿小组和一个大学 PPI 咨询小组进行了 PPI 参与。利益相关者活动：家长、卫生专业人员以及苏格兰政府、学术界、慈善机构和 PPI 的代表参加了活动。
对包括 92229 例短期住院在内的 171039 例住院数据进行了分析，并对 48 名卫生专业人员和 21 名家长进行了访谈。利益相关者活动包括 7 名家长、12 名卫生专业人员和 28 名其他利益相关者。对所有数据的分析和综合确定了七个干预措施，这些措施在利益相关者活动中被优先考虑：（1）解决在社区环境中工作的卫生专业人员急性儿科技能方面的差距；（2）在社区环境中对急性不适的儿童进行评估和观察；（3）创建整体儿童“中心”；（4）采用“医院居家”模式；以及三种针对儿童亚组的专门护理途径；（5）癫痫发作；（6）年龄<2 岁；（7）喘息/细支气管炎。利益相关者优先考虑措施 1、2 和 3；这些措施可以结合成一个全人群干预措施。推进这些措施的障碍包括资源、人员配备和农村地区。
卫生专业人员和家庭希望未来的干预措施以患者为中心、以社区为基础，并与他们关心的结果保持一致。
