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Evaluating a community respiratory physiotherapy service for children with neurodisability
Samantha Smith1, Moira Flanigan2, Sarah Haynes3
1The Children's Development Centre, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK samantha.smith@nottshc.nhs.uk.
Insights
The Children's Community Respiratory Physiotherapy Service (CCRPS) significantly improves respiratory health in children with neurodisability, preventing hospital admissions and enhancing patient/parent satisfaction. This specialized service proves highly effective and cost-efficient.
Area of Science:
- Pediatric Respiratory Medicine
- Neurodisability Care
- Healthcare Service Evaluation
Background:
- Children with neurodisability face heightened risks of respiratory complications, leading to frequent hospitalizations and mortality.
- The Children's Community Respiratory Physiotherapy Service (CCRPS) was established in 2010 to provide home-based support for acute chest infections in children with severe neurodisabilities.
- CCRPS aims to prevent emergency department visits and hospital admissions, evaluating its clinical and cost-effectiveness amidst rising demand.
Purpose of the Study:
- To evaluate patient and parent satisfaction with the CCRPS.
- To assess the service's effectiveness in preventing hospital admissions for respiratory tract infections.
- To determine the clinical and cost-effectiveness of the CCRPS.
Main Methods:
- A Picker feedback survey was administered to patients and parents/carers over a 3-month period following 100 emergency visits.
- Existing CCRPS data was used to identify the number of prevented hospital admissions for respiratory tract infection over a 12-month period (April 2019-March 2020).
- Estimated hospital admission costs saved were calculated based on prevented admissions.
Main Results:
- Picker survey responses were overwhelmingly positive, with all participants reporting satisfaction with care and problem resolution.
- The CCRPS prevented an estimated 182 hospital admissions for respiratory tract infection in 2019/2020.
- This prevention equated to 1638 bed days saved and estimated cost savings between £751,728 and £1,009,986.
Conclusions:
- The CCRPS significantly enhances the quality of life and patient experience for children with neurodisability and their families.
- The rapid response service effectively prevents hospital admissions for respiratory infections in this vulnerable population.
- The cost savings generated by preventing admissions demonstrate the CCRPS's strong financial viability, more than covering its operational costs.
Background:
Children with neurodisability are at an increased risk of respiratory problems and complications, which often result in prolonged, frequent hospital admissions and are the biggest cause of mortality in this client group. The Children's Community Respiratory Physiotherapy Service (CCRPS) was established in 2010 to support children with severe neurodisabilities at home during acute chest infections and to prevent emergency department attendances and hospital admissions. This service evaluation looked at patient/parent satisfaction and prevented admissions to ensure clinical and cost-effectiveness, despite the rising demand for the service.
Methods:
Over a 3-month period, patients and parents/carers on the CCRPS caseload were given a Picker feedback survey following 100 emergency visits from the team. The number of prevented hospital admissions for respiratory tract infection over 12 months (April 2019-March 2020) was identified from existing CCRPS data and hospital admissions costs saved were estimated.
Results:
The Picker survey responses were extremely positive with all respondents reporting that they felt well looked after and that the main reason for the emergency visit was dealt with well. Based on key indicators, the CCRPS prevented 182 hospital admissions for respiratory tract infection in 2019/2020, equating to 1638 bed days and estimated cost savings ranging between £751 728 and £1 009 986.
Conclusions:
The Picker survey response demonstrates the positive impact that the CCRPS has on both quality of life and experience for patients and families. The CCRPS rapid response service prevents hospital admissions for respiratory tract infections in children and young people with severe neurodisability and the cost savings from admissions prevented allows the service to more than pay for itself.
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