Evidence map›Paper›PMID 29637196›Full record

ArticleBMJ paediatrics open2018

Interventions for reducing unplanned paediatric admissions: an observational study in one hospital.

Kerryn Husk, Vashti Berry, Richard Tozer, Gina Skipwith, Robert Radmore, Susan Ball, Obioha C Ukoumunne, Stuart Logan

Abstract read
In one paragraph

Article in BMJ paediatrics open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Kerryn HuskNIHR CLAHRC South West Peninsula (PenCLAHRC), Faculty of Medicine and Dentistry, University of Plymouth, Plymouth, UK.ORCID 0000-0001-5674-8673
Vashti BerryNIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter Medical School, University of Exeter, Exeter, UK.
Richard TozerTorbay and South Devon NHS Foundation Trust, Torbay Hospital, Torquay, UK.
Gina SkipwithTorbay and South Devon NHS Foundation Trust, Torbay Hospital, Torquay, UK.
Robert RadmoreTorbay and South Devon NHS Foundation Trust, Torbay Hospital, Torquay, UK.
Susan BallNIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter Medical School, University of Exeter, Exeter, UK.
Obioha C UkoumunneNIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter Medical School, University of Exeter, Exeter, UK.
Stuart LoganNIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter Medical School, University of Exeter, Exeter, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveEvidence on how best to intervene to improve paediatric acute care and therefore reduce unplanned hospital admissions is weak. We describe service evaluation work at one hospital to assess interventions at critical clinical and service decision points.

designWe conducted an observational study using routine daily-collected data (April 2009-December 2015) from a medium-sized district general hospital in south-west UK, using before-and-after comparisons of admissions-related data to evaluate two interventions implemented in April and November 2014, respectively: (1) an advice and guidance (A&G) phone line, where a senior paediatrician is available for general practitioners (GPs) and emergency department (ED) and (2) a Short Stay Paediatric Assessment Unit (SSPAU). We analysed data on all admitted children (<18 years) in the catchment area (population estimate 27 740 in 2015). Outcomes were GP-referred attendances, ward admissions, less than 1 day admissions and length of stay.

resultsA&G phone line was associated with a reduction in the mean number of less than 1 day admissions per month (difference in means before and after intervention -16.6 (95% CI -0.2 to -32.9)) and an increase in overall monthly bed-days (difference 72.5 (95% CI 21.0 to 124.0)), but there was little evidence of a change in GP-referred attendances or ward admissions. SSPAU was associated with a reduction in the mean number of monthly ward admissions (difference -34.6 (95% CI -21.3 to -48.0)) and less than 1 day admissions (difference in means -21.7 (95% CI -8.4 to -35.1)) and a reduction in the mean number of overall bed-days per month (difference -50.2 (95% CI -12.1 to -88.3)).

conclusionsInterventions for reducing time taken to senior clinician review may be effective in better managing paediatric acute care. Further work should explore results by age, condition and injury/illness status.

Indexed as

general paediatricshealth services research

Identifiers

PMID29637196
PMCPMC5887827

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.