Thursday 20 th September 2012 The Copthorne Hotel
NHS Dudley & GlaxoSmithKline ‘Excellence in Asthma’ Project July 2011 - June 2012 Dr Mark Hopkin GP & Clinical Lead
Excellence in Asthma - Background Commitment & Clinical Engagement of Practices in Respiratory already existed. The aim of this project was to improve the quality of asthma care across practices in Dudley by providing education. Practices were encouraged to aspire to a High Standard of Care which was defined by the Dudley ‘Excellence in Asthma’ Award. This required seven criteria to be met:
Excellence in Asthma 1. Practice will have a named Asthma GP & Nurse Lead 2. Named Asthma GP & Nurse will attend a 3 hour training session 3. To provide a Structured Asthma Review using READ codes provided 4. Record BTS Step of asthma 5. The practice will use the DRG Self Management Plans 6. The practice will conduct 20 adult & 5 children's Patient Satisfaction Questionnaires 7. Asthma Nurse and GP will complete a HCP questionnaire
Excellence in Asthma • The Project Steering Group had representation from Primary Care, Commissioning, Provider, Medicines Management and GlaxoSmithKline • All Dudley GP Practices were invited to participate in the Asthma In Excellence Project • The project started in July 2011 and completed end of June 2012
‘ Sign Up’ • All Dudley GP Practices signed up to the project (100%)
Support Materials • Dudley Asthma Treatment Guidelines • Dudley Asthma Action Plans • Structured Review – READ codes
Support Materials – cont’d • Inhaler Boxes & Devices • Dudley Respiratory Group Website www.dudleyrespiratorygroup.org
Evaluation of the Project • The success of the project was evaluated by: – A patient satisfaction questionnaire to assess patients’ perceptions of their care and disease understanding following their annual asthma review. – A questionnaire of Healthcare Professionals to assess the impact of the education. – Engagement and Sign up of practices to the project – Attendance at the Training Days – Partnership working with Pharmaceutical Industry • The potential impact of the project upon longer term measures such as hospital admissions data can be assessed fully in due course.
‘Excellence in Asthma’ Evaluation Joanne Hamilton Lead Nurse - Respiratory
Excellence in Asthma • 7 Training Sessions June 2011 – March 2012 • Different Locations • 130 Health Care Professionals attended • 3 hour session including paediatric and adult asthma management • As a consequence of these sessions 3 in house one day training sessions - 38 HCPs Asthma Diploma – 20 HCPs
Health Care Professional Survey Evaluation of the Dudley Excellence in Asthma education programme September 2012
Did our education upskill Healthcare Professionals? Methodology • A paper based questionnaire given to healthcare professionals at the end of the asthma in excellence project • The Lead GP & Lead Nurse were asked to complete the questionnaire. • Questionnaires were returned by Fax or Courier to a designated address
Health Care Professional Evaluation Questionnaire – Overview of respondents • 75 respondents – Including 52% Practice Nurses, 39% GPs. • 43% had no previous accredited asthma training. • 85% run an Asthma clinic within their practice.
How valuable has the education been improving HCPs’ understanding of core knowledge? • 95% found the education valuable/extremely valuable on inhaler technique • 92% found the education valuable/extremely valuable on how to provide a structured review. Thinking about the education that you Not at all Of limited Valuable Extremely have received... how valuable has it been valuable value valuable in improving your understanding of........ How to diagnose children’s asthma 0% 9% 62% 29% Optimum prescribing for children with 0% 9% 58% 33% asthma How to manage acute asthma in children 0% 10% 60% 30% Dudley local guidelines on the management 0% 1% 52% 47% of asthma How to classify patients according to 0% 7% 57% 36% BTS/SIGN steps The importance of inhaler technique 0% 5% 48% 47% The importance of compliance 0% 8% 45% 47% How to provide a structured asthma review 0% 7% 47% 47%
Following the education .... knowledge of diagnosing children’s asthma has improved significantly 50% 45% 43% 40% 35% 30% 25% 25% Before 21% 19% 19% 20% After 14% 15% 13% 11% 10% 7% 7% 5% 5% 5% 3% 3% 3% 3% 0% 0% 0% 0% 0% 1 2 3 4 5 6 7 8 9 10 On a scale of 1 to 10 how to knowledgeable were you before and after the education in diagnosing children’s asthma. 1= Not knowledgeable at all; 10=extremely knowledgeable. Total Respondents = 73
following the education ... knowledge of optimum prescribing in children’s asthma has improved significantly. 40% 38% 35% 30% 25% 22% 20% 20% Before 18% After 14% 14% 15% 12% 12% 11% 10% 8% 7% 7% 7% 4% 4% 4% 5% 0% 0% 0% 0% 0% 1 2 3 4 5 6 7 8 9 10 On a scale of 1 to 10, how to knowledgeable were you before and after the education in optimum prescribing for children with asthma. 1= Not knowledgeable at all; 10=extremely knowledgeable. Total Respondents = 74
Following the education .... knowledge of how to manage acute asthma has improved significantly 45% 39% 40% 35% 30% 28% 25% 25% 21% Before 20% After 15% 15% 13% 12% 11% 11% 10% 8% 7% 5% 3% 3% 3% 1% 1% 0% 0% 0% 0% 0% 1 2 3 4 5 6 7 8 9 10 On a scale of 1 to 10, how to knowledgeable were you before and after the education in how to mange acute asthma. 1= Not knowledgeable at all; 10=extremely knowledgeable. Total Respondents = 75
Knowledge of the Dudley local guidelines has improved significantly 40% 36% 35% 32% 30% 25% 23% 20% 20% Before After 15% 15% 13% 13% 13% 9% 10% 7% 5% 5% 4% 5% 3% 1% 0% 0% 0% 0% 0% 0% 1 2 3 4 5 6 7 8 9 10 On a scale of 1 to 10, how to knowledgeable were you before and after the education of the Dudley Asthma Respiratory Guidelines. 1= Not knowledgeable at all; 10=extremely knowledgeable. Total Respondents = 75
Knowledge of how to classify patients according to BTS/SIGN steps has improved 45% 39% 40% 35% 30% 28% 25% 21% 21% 21% Before 20% After 15% 13% 12% 11% 10% 8% 7% 5% 4% 4% 5% 3% 1% 1% 0% 0% 0% 0% 0% 1 2 3 4 5 6 7 8 9 10 On a scale of 1 to 10, how to knowledgeable were you before and after the education in classifying patients according to BTS/SIGN steps. 1= Not knowledgeable at all; 10=extremely knowledgeable. Total Respondents = 75
Knowledge of the importance of inhaler technique has improved 50% 47% 45% 40% 35% 28% 30% 27% 25% Before 22% After 20% 16% 15% 15% 12% 11% 10% 5% 4% 5% 3% 3% 3% 3% 1% 0% 0% 0% 0% 0% 0% 1 2 3 4 5 6 7 8 9 10 On a scale of 1 to 10, how to knowledgeable were you before and after the education around the importance of inhaler technique. 1= Not knowledgeable at all; 10=extremely knowledgeable. Total no of Respondents = 74
Knowledge of the importance of compliance in asthma has improved 50% 47% 45% 40% 35% 31% 31% 30% 25% Before 22% 19% After 20% 15% 15% 9% 10% 7% 7% 4% 5% 3% 3% 1% 1% 0% 0% 0% 0% 0% 0% 0% 1 2 3 4 5 6 7 8 9 10 On a scale of 1 to 10, how to knowledgeable were you before and after the education around the importance of compliance in asthma. 1= Not knowledgeable at all; 10=extremely knowledgeable. Total Respondents = 74
Knowledge of how to provide a structured asthma review has improved 45% 40% 40% 35% 33% 30% 25% 22% 21% Before 19% 20% After 16% 15% 12% 12% 10% 8% 5% 5% 5% 3% 3% 0% 0% 0% 0% 0% 0% 0% 0% 1 2 3 4 5 6 7 8 9 10 On a scale of 1 to 10, how to knowledgeable were you before and after the education around how to provide a structured asthma review. 1= Not knowledgeable at all; 10=extremely knowledgeable. Total Respondents = 73
What impact has the education had upon behaviour within a ‘typical’ asthma review?. • As a direct result of the education, 76% of HCPs are now using the asthma control test (ACT) to assess asthma control as part of ‘typical’ reviews, and • 74% are now using self management plans. Which of the following is part of a ‘typical’ asthma I rarely/never Yes, as a result Yes, I always review that you now conduct for patients? do this of the Asthma have done training this A structured asthma review based upon the READ 4% 61% 35% codes provided by Dudley Respiratory Group Completion of the 5 ‘Asthma Control Test’ (ACT) 4% 76% 20% questions Assessment of which BTS/SIGN asthma ‘step’ a 1% 62% 36% patient is currently on Review of a patients asthma medication 0% 22% 78% Review of a patient inhaler technique 0% 24% 76% Smoking cessation advice 0% 13% 87% The Dudley Asthma Action Plan (self management 0% 74% 26% plan) Flu vaccinations 0% 10% 90%
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