Archive September 2018

A story of two halves… key lessons learned on my PICH journey

I began my PICH journey with enthusiasm, but little experience of leading QI projects. I firstly introduced a proforma to our ED to help standardise the acute care of wheezy children and improve the advice and education given at discharge. Several iterations of audit showed that we were making improvements to acute care and also discharge advice and education. Following this, I noted that many patients referred to paediatrics from our  UCC were seen and sent home with few, if…

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Service Development; Initiation of Learning Together Clinic

As part of my PICH Journey- I had the opportunity to sit in a Learning Together Clinic which in my opinion was a great example of delivering patient centred care. I worked towards setting up the clinic within the paediatric rota. After overcoming local barriers such as consultant provision, rota management, identifying stakeholders and approval from GP practice manager, I was able to establish the clinic within the paediatric training rota. A number of registrars have done this clinic with…

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Child Sexual Exploitation in Hillingdon

Definition: CSE involves those under 18 in exploitative situations, contexts and relationships where young people (or a third person or persons) receive something (for example, food, alcohol, cigarettes, affection, gifts) as a result of them and/or another or others engaging in sexual activities. It is an abuse of power by those exploiting by virtue of their age, gender, intellect, and physical strength and/or economic or other resources. 1 in 20 children in the UK have been sexually abused Sexual exploitation accounted…

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Nephrotic syndrome, a paradigm for integrated care approaches in Paediatric Nephrology

Embarking on my journey in PICH, I have been overwhelmed by enthusiasm about how PICH is changing the world of Paediatrics. Paediatrics is soon going to be a place of continuity of care, so much closer to what I have envisaged as a clinician and parent. I gradually realised that the majority of my tertiary care colleagues would not immediately share this enthusiasm and it would take time, advanced leadership skills and data to convince them of the potential for…

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Learning about micro-scale, big scale & international scale helps! Lots of small started projects!

I already have a background of being a GP. I have already tried examples of adult integrated health care which are useful examples. I have previously attempted integrated healthcare in paeds by means of GPSI (GP with specialist interest) clinics. I looked into examples of which other countries are doing it and evidence as to whether integrated care models work (they do – well at least in adults). I tried some of my own examples – but generally managed to…

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Better integrated care: Empowering patients and professionals through co-designed training

I was really excited to design an integrated care project supporting training of professionals and the public.  The aim was to improve the patient experience by empowering patients and families with knowledge and improving understanding of professionals involved in child health to allow more streamlined integrated care for children and young people. I created a stakeholder group by recruiting colleagues who shared my values of delivering high quality education to professionals and parents to enable better integrated care.  Through collaboration…

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Standardising the care of babies presenting with Prolonged Jaundice

As a GP trainee, I have been fortunate to see the many facets of the patient journey as they navigate primary, acute and secondary care service. My project was inspired from my time as a Paediatric SHO, where I helped run a prolonged jaundice clinic, but found a lack of standardisation in investigations, dedicated clinic slots, and poor communication with primary care referrers (highlighted to me as a GP SHO), and guidance for juniors. I noticed first-hand the anxiety this…

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Empowering parents in their child’s care

My project started with a view to reducing attendance and encouraging parents/patients to self-manage common medical issues. I started by looking at practice data of ‘frequent attenders’ and talking to them about what they worry about/why they attend. From there it seemed that they would like resources that could help them – most were unaware of NHS Choices and signposting to this was a real help to them. From there I thought about how to deliver teaching to parents about…

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My PICH journey so far

I started PICH with the idea of expanding on a project I had previously been involved with (along with Sarah Burkitt, another PICH participant) on improving care for children with autism in the A+E environment. We looked at ways to develop this idea in the community and approached a local parent-run group to attend their sessions, and talk to parents of children with autism about the issues they faced in the community and where they would like to see improvements.…

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