Walsall paediatric asthma pathway Walsall Healthcare NHS Trust

This project aimed to:

• support families to know how to manage asthma when well, preventing exacerbations, and when unwell, save health care resources if not needed
• increase staff morale through them becoming more engaged and empowered in improving the care delivered.

The team collected patient stories through shadowing and direct observation to map the existing pathway experienced. Then experience based co-design was used to create the ideal process, including patients, carers and frontline staff as much as possible.

It was identified that the discharge process could be improved and better use made of the time families were in hospital. This was done by improving the information given as well as using tools such as a discharge bundle and a personalised asthma plan.

Elements of the discharge bundle included:

• ensuring the patient is clinically fit for discharge
• patient’s parents feel confident for the family to go home
• patient's asthma inhaler technique is assessed as competent
• patient given asthma self-management plan, advice leaflet and medication for use at home
• peak Expiratory Flow Rate Meter and diary given
• follow up arranged (open access/GP/Community Nurse/hospital).

Through the project, the time from the decision to discharge to leaving the ward was reduced and sharing information with carers, GPs and schools at the point of discharge helped ensure families received the support needed.

The project was clinically led but benefited from input from a variety of stakeholders including the third sector, education and IT as well as health care professionals in the community such as GPs, health visitors and school nurses.