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Bevan Exemplar Cohort 7 Projects

Breath of Fresh Air! Paediatric Respiratory Physiotherapy Outreach Rapid-response Service

Samantha Davies, Mari Powell and Briony Guerin

Swansea Bay University Health Board

Watch Samantha Davies talk about her project.

Children and young people (CYP) with complex Cerebral Palsy (GMFCS IV and V) have abnormal muscle tone and postural deformities, which restrict lung function. These CYP are susceptible to recurrent respiratory infections.  Relaxation of Covid-19 measures in 2021 prompted a global, non-seasonal surge in Respiratory Syncytial Virus (RSV), a common childhood lower respiratory tract infection. RSV causes bronchiolitis or pneumonia, often hospitalising children. To protect these vulnerable CYP a proposal was made to pilot an outreach-in reach, rapid response service.

“For children who are in and out of hospital all their life, someone coming to the house to help with respiratory physio really relieves the stress and anxiety.”

Project Aims and Objectives:

Based upon population health strategies, the project aimed to deliver cost-effective, prudent, innovative, sustainable healthcare to the CYP of Swansea Bay University Health Board (SBUHB) area.

The objectives were to reduce A&E/PAU/hospital admissions, reduce length of stay with early supported discharge, to educate parents/carers to self-manage the CYP and improve quality of life (QoL) for the CYP and their family.

Project Approach:

This is the first paediatric outreach respiratory service in Wales for CYP with complex disability.

Services were benchmarked across the UK and a Nottingham-based model was adapted for our local population.

A collaborative approach was taken, engaging parents, Allied Health Professionals and medics to create a new service delivery plan. Questionnaires were issued to parents to establish baseline data and pathways were streamlined in an iterative approach to feedback.

Project Impact:

Data from PROMs and PREMs:
➢ significant improvement in Quality of Life measures for whole family
➢ improved patient-centred care/MDT working
➢ Reduced parental anxiety
➢ Improved sleep
➢ Improved voice projection
➢ Increased alertness
➢ Improved ability to chew and swallow food effectively

Project Outcomes:

  • 16 admissions were prevented, plus an additional 55 bed days saved compared to 2021 data.
  • 6 admissions prevented; 5 bed days saved compared to 2019 data.
  • Average of 14 bed days saved per annum for assessment-only admissions lasting 1-2 days each.
  • Cost benefit over 8-months a minimum of £28,350.

View the project poster and slides from Cohort 7 Exemplar Showcase