Avoiding Hospital Admissions HIT review of 2013-14

Professor Sarah Purdy reviews the 2013-14 work of the Avoiding Hospital Admissions Health Integration Team (ITHAcA HIT).

It has been
a productive year for the Integration to Avoid Hospital Admissions (ITHAcA) HIT.
We have focused on our aims to reduce the complexity in the urgent care system and
to develop the capacity to use data in evaluating changes and optimising the productivity
of existing and new interventions. ITHAcA has four priority themes: using data to
inform commissioning; chronic obstructive disease (COPD); dementia and childhood
asthma.

Our programme
of work has begun with a focus on COPD, with an application to the NIHR Health
Services and Delivery Research programme to evaluate admission and discharge care
bundles for people with COPD in collaboration with the British Thoracic Society:
we are waiting for final confirmation of funding. We have also recently completed
a locally funded study to explore the feasibility of using a systems dynamics modelling
approach to understand and reconfigure services available for patients with COPD.
Local funding has also been obtained to look at a systematic review of case management
in heart failure. Other applications recently submitted include a Programme Development
Grant on managing uncertainty to reduce emergency bed days for older people and a small
grant to examine the feasibility of applying a systems dynamics approach to investigating
dementia services.

We are also
focusing on the development of the HIT as an information repository, through the
creation of a website offering information about avoidable admissions. From our
recent circulation of documentation, a request was made for a virtual wards meeting,
which was attended by six senior Bristol, North Somerset and South Gloucestershire NHS staff. The aim
was to review the evidence and think about how to develop this initiative locally.
From this discussion a request was made for a systematic review of virtual wards,
which is being prepared for submission to CLARHC West.

Future plans include
exploring evaluating the use of voluntary sector services to reduce admissions,
and working in partnership with clinical colleagues to support an evaluation of
an existing discharge service aimed at reducing future hospital admissions.