Entering the asthma big room

My time working on the general paediatric wards as a second year doctor is nearly up. I’ve had a fantastic few months working with wonderful people and I have learnt a lot about looking after unwell children. But I want to talk about something else I was lucky enough to get involved with.

When I first heard about the ‘asthma big room’, I thought it sounded a little ominous, but I was intrigued. And so I turned up one afternoon to what was, in fact, quite a small room, and took my seat amongst a whole range of different professionals. Over the course of the next hour I heard about some of the things this group of inspirational people were trying to achieve. The scale of this improvement project quickly became apparent.

So why are we doing this?

The asthma big room aims to improve the recognition and management of asthma and wheeze in children throughout north west London, through the delivery of consistent, high quality, person-centred care. That is no mean feat!

Asthma is one of the UK’s commonest childhood conditions and costs the NHS more than £1.1 billion a year, according to Asthma UK. One in 11 children in the UK have asthma, and for many their asthma will persist into adulthood. Each day in the UK three people die from asthma. A devastating fact is that two thirds of these deaths are preventable. Working on the paediatric wards I have seen dozens of asthmatic children, many of whom are not optimally managed.

What did I do?

Parents of children with common illnesses tell us they receive different guidance from different professionals, which patients find confusing. Having been tasked with collecting some baseline data about how we are managing asthmatic children in hospital, I noticed that very few children are being sent home with a personalised asthma action plan. This traffic light coded plan outlines how and when you should take your inhalers and describes the signs that you may be having an asthma attack. Using a personalised asthma action plan has been shown to reduce the likely need to come to hospital because of your asthma. The British Thoracic Society (BTS) guidelines state that all children who are seen in hospital for their asthma should leave with one.

So what’s next?

Work is underway to create a new electronic personalised asthma action plan. This will be built into Cerner (our clinical computer system) and will automatically be sent to the parents and the GP when the child is discharged. We hope that by facilitating the use and distribution of these plans we can reduce the number of asthma admissions in north west London.

This is just one of the many lines of improvement the asthma big room is currently involved in; I can’t wait to see what we will achieve next!