Using London Ambulance Service activity as a metric for quality improvement in asthma, assessment of activity data

Abstract

Aim The Healthy London Partnership (HLP) aims to improve quality of care in the capital, with a focus on children and young people, who face some of the poorest health outcomes compared with the rest of the country. Using the distribution of paediatric asthma emergency calls to London Ambulance Service (LAS) as a metric, and the HLP Asthma toolkit, we can assess the impact of our findings. Methods We gathered data from the LAS for all asthma related calls during the period of 01/01/2015 to 01/01/2016 regarding paediatric calls, ages 0–19 years. Data was analysed with attention to the distribution of calls against time, gender and conveyance to hospital. Results In the period analysed, there were a total of 10 498 asthma calls to the LAS, where 80.53% of calls were conveyed to Emergency Departments (EDs). 2946 (28.06%) were made from the 0 to 19 years age group. In the 0 to 4 years age group, 68.52% of calls were for males, to 31.48% of females in the same age group (5.39% to 2.47% respectively of all calls). There is a greater incidence of calls from males until 15 years, later more are from females. From the total number of calls, 5829 (55.52%) were made for females, with the highest incidence in September (9.94%). Weekly analysis shows most calls are made on Monday (15.91%), the busiest times are between 10am– 12pm, and from 7 pm to midnight. The data presented is generic, not specific to the location or severity of calls, but it can facilitate whole system changes. Conclusions Age, gender and time distribution of calls to the LAS provide a useful metric to enable strategies for a London-wide system change. This can be assessed using the HLP toolkit, which has provided examples of good practise and audit strategies, accessible to all healthcare providers. The data from our research can improve asthma education to parents, teachers and carers, and highlight areas for improvement. This ensures everyone involved in asthma care can benefit from the findings of our research. https://adc.bmj.com/content/102/Suppl_1/A9.3 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ http://dx.doi.org/10.1136/archdischild-2017-313087.21