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Showing posts from March, 2014

Risk Factors for Hospital Admission with RSV Bronchiolitis

In a paper published in the journal PLOS ONE . Jo Murray and colleagues examined the timing and duration of hospital admissions from respiratory syncytial virus (RSV) bronchiolitis among term and preterm infants in England and to identify risk factors for admission. We carried out a population-based birth cohort with follow-up to age 1 year, using the Hospital Episode Statistics (HES) database using data from 71 hospitals across England. We identified 296618 individual birth records from 2007/08 and linked to subsequent hospital admission records during the first year of life. In our cohort, there were 7189 hospital admissions with a diagnosis of bronchiolitis, 24.2 admissions per 1000 infants under 1 year (95% CI 23.7–24.8), of which 15% (1050/7189) were born preterm (47.3 bronchiolitis admissions per 1000 preterm infants (95% CI 44.4–50.2)). The peak age group for bronchiolitis admissions was infants aged 1 month and the median was age 120 days (IQR = 61–209 days). The median leng...

PACK: Practical Approach to Care Kit

I attended a very interesting seminar today organised by C3Health at Barnabas House in London at which Dr Lara Fairall from the University of Cape Town presented on the PACK (Practical Approach to Care Kit) programme. The PACK programme has been developed over the last 12 years in South Africa. PACK is a set of comprehensive clinical practice guidelines that aims to equip nurses and other clinicians to diagnose and manage common adult conditions at primary care level. It includes information on symptoms, clinical evidence, policy-based guidelines and training. Dr Fairall spoke about the background to the programme, how the information sources were complied and how the programme (which is nurse-led and based in primary care) was delivered. PACK is led from the Knowledge Translation Unit at the University of Cape Town. Thanks to Dr Richard Smith for the invitation.  Dr Richard Smith and Dr Lara Fairall  Some of the delegates networking before the start of the pr...

Launch of the North-West London CLAHRC

On Tuesday 4 March 2014, I attended the launch of the NIHR CLAHRC for North-West London  at the Royal College of Physicians of London. NIHR Collaborations for Leadership in Applied Health Research and Care ( CLAHRCs ) undertake high-quality applied health research focused on the needs of patients and support the translation of research evidence into practice in the NHS. CLAHRCs are collaborative partnerships between a university and the surrounding NHS organisations, focused on improving patient outcomes through the conduct and application of applied health research. They create and embed approaches to research and its dissemination that are specifically designed to take account of the way that health care is increasingly delivered across sectors and a wide geographical area. You can view a selection of pictures from the event below. Dr Vasa Curcin and Dr Tom Woodcock are pictured outside the Royal College of Physicians building in Regent's Park. Dr Chris Millett, Read...

Why do patients attend GP-led urgent care centres rather than their own general practice?

In a paper published in the Emergency Medical Journal , my colleagues and I investigated why patients with 'minor; illnesses choose to attend a GP-led urgent care centre rather than their own general practice. The demand for urgent care is increasing, and the pressure on emergency departments is a significant concern for the NHS. General practitioner (GP)-led urgent care centres are a new model of care developed to divert patients from emergency departments to more appropriate primary care environments. We administered a self-completed questionnaire among patients aged 18 years or over (N=649) who were triaged with a ‘minor illness’ on arrival to an urgent care centre, co-located with an emergency department in London. We found that the median age of patients was 29 years. 58% of patients attending the centre with minor illness during the study period took part. 72% of participants were registered with a GP; more women (59%) attended than men; and the majority of participants r...