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Case study 1: Improving the experience of children with asthma

The PFCC team at Walsall Manor Hospital chose to work to improve the experience of children with asthma, following a patient safety incident some years earlier. The team felt that nationally, management of asthma could be better, and they wanted to work on this as a local priority.

Specifically, the team wanted to work with patients to co-design the new pathway and make it more clinically consistent as well as improving the experience for children and families.

Initially, the team wanted to transform the whole experience across the health economy. But as time went on, they became aware of the enormity of the task they had set themselves, and they decided to concentrate on arrangements for discharge as their first project, with other aspects of care to follow later.

The team embraced the PFCC method, establishing a guiding council and working groups, and meeting regularly. They also made sure that shadowing was carried out by a number of team members. Many of the clinical team were involved in the work, as well as service users, and it was led by two consultant paediatricians. The organisation also put in place some project support to help the team.

Eventually, the team focused on three specific projects. The first focused on clarifying the process of care from admission to discharge, and producing a patient journey map. The second involved developing resources for families to increase their knowledge about asthma and their confidence in managing it. The third involved implementing follow-up phone calls for families after their children came home from hospital.

The team made some improvements in the process of care, and worked with colleagues to carry out small tests of change, to improve the care bundle until they felt confident with it. Patients and families reported finding the new resources useful.

The team’s work to shadow patients had unintended consequences, too. It helped them to think about new ways to make the environment more user-friendly. For example, one of the first signs visible on entering the ward points to the ‘resuscitation room’. They considered how, from the families’ point of view, it might feel to read this on first arriving.

The team’s successes have fuelled their enthusiasm to spread the PFCC method to other care experiences and, as some members of the team have moved to other organisations, to spread it to other parts of the NHS.

Case study 2: Improving the care of children with acute abdominal pain