A cross-sector asthma care approach to reduce hospitalisations for children with asthma (Katherine Chen)

A cross-sector asthma care approach to reduce hospitalisations for children with asthma (Katherine Chen)

Dr Katherine Chen Murdoch Children’s Research Institute Dr Katherine Chen is a paediatrician, Clinician Scientist Fellow, and Clinical Lead of Short Stay Unit which cares for the majority of children admitted for asthma at The Royal Children’s Hospital. In addition to her clinical experience, she brings her expertise in asthma, mixed methods research, linked administrative datasets having led the multi-centred Childhood Asthma Readmissions (CARE) study. The CARE study highlighted the increasing burden of asthma hospital readmissions in Victoria and the gaps in care especially around cross-sector collaboration. Dr Chen was the clinical lead for the community of practice and integration of care components of Improving Childhood Asthma Management (ICAM) pilot and will continue on as the Clinical Research Fellow Lead for the expanded project ICAM 2.0 as part of Safer Care Victoria’s 100,000 Lives Collaborative. The evaluation will also involve Professor Harriet Hiscock, Dr Shivanthan Shanthikumar, Professor Kim Dalzeil, Dor Danny Csutoros, and Ms Rachel Vorlander. Project Status: In progress, commenced July 2023 Grant Type: Project grant

There are well-established and best practice asthma guidelines in Australia. However, many components of the guidelines are not adhered to consistently in the healthcare system. This contributes to the high number of hospitalisations for children in Australia.

The Improving childhood Asthma Management (ICAM) Project in Victoria is trying to change this through a cross-sector asthma care approach.

That’s why we are funding Katherine Chen, at the Murdoch Children’s Research Institute, to evaluate the ICAM project and provide the evidence needed to translate this widely into practice.

About the research

The Victorian Government have been funding the ICAM Project in the Inner West Melbourne between 2021 – 2023. ICAM brings together:

• The Department of Health
• Royal Children’s Hospital
• Sunshine Hospital
• Co-Health Community Service
• National Asthma Council
• Northwest Melbourne Primary Health Network
• Safer Care Victoria
• Families of children with asthma
• And us – Asthma Australia

The team worked together to improve identified gaps in asthma care including Asthma Action Plan use, early GP follow ups after hospital presentations, and referrals to community asthma services. Learnings from the pilot ICAM project will be used in the expanded ICAM 2.0 Project in North-West Melbourne.

We now want to know if ICAM is effective and cost-effective in reducing emergency department presentations and hospitalisations for children aged 1-18 living in the Inner West.

To do this Dr Chen, and the research team, will:

• Analyse routine data collected by participating general practices.
• Analyse monthly surveys from participating health professionals.
• Examine change in emergency department presentations before and after the ICAM project.
• Conduct focus groups with families and children, doctors, and hospital medical and nursing staff.

They will also repeat this data collection and analysis after the funding ends to understand the sustainability of these initiatives.

Why was funding this research important?

There are well established best practice asthma guidelines for care. However, many components are not followed consistently by healthcare systems and professionals. This contributes to the large numbers of children presenting to hospital each year for their asthma.

Each hospital presentation for asthma can be a traumatic experience, an event that is frightening, and one that interferes with a child’s day-to-day wellbeing, and their ability to participate, grow and enjoy their life. These presentations also add significant burden to the healthcare system, which could be avoided.

“There are many opportunities to improve asthma care across the whole system including strengthening education, increasing access to regular proactive primary care visits, addressing gaps in guideline adherence and improving cross-sector communication.” – Dr Katherine Chen

The results of this evaluation will inform a sustained model of the effective components, to build it into daily practice. If effective, this evaluation will provide valuable information to guide the expansion of this approach to other areas to help reduce childhood asthma hospitalisations.

The funding for this project was generously provided through the Ray O’Donnell Belgrave Lions Asthma Research.