Time to act to solve gaps in practice: The BSACI National Allergy Education Strategy

Vance, Gillian; Ludman, Siân; Angier, Elizabeth; Kelman, Margaret; Denton, Sally‐Ann; Wright, Karen A.; Gowland, M. Hazel; Holloway, Judith A.

doi:10.1111/cea.13808

Cited by 5 publications

(10 citation statements)

References 8 publications

(11 reference statements)

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“…We highlighted the need to solve these gaps in practice in earlier editorials 1,2 which heralded the initiation of a strategy development process. Since then, over 50 doctors, nurses, dietitians, health visitors and pharmacists from across the United Kingdom have worked in concert with patient representatives to form a true community of practice (Figure 1).…”

Section: E D I T O R I a L Bsaci National Allergy Education Strategy ...mentioning

confidence: 99%

BSACI national allergy education strategy for healthcare professionals

Holloway

Vance

Angier

et al. 2022

Clin Experimental Allergy

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Section: E D I T O R I a L Bsaci National Allergy Education Strategy ...mentioning

confidence: 99%

BSACI national allergy education strategy for healthcare professionals

Holloway

Vance

Angier

et al. 2022

Clin Experimental Allergy

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“… 35 In a similar vein, BSACI identify representatives of patient support organizations to be key in the development of a recent National Allergy Education Strategy. 36 However, currently, guideline development rarely involves patients and care-givers, which is likely to jeopardize patient outcomes. 37 …”

Section: Guideline Development With Patient/caregiver Involvementmentioning

confidence: 99%

“…A similar process can be applied to other aspects of allergy care, for example in the design of education and training strategies. This has been demonstrated by BSACI who recently formed an Allergy Education Network, 36 comprising of a range of HCPs from different settings, clinical academics, and representatives from patient support organizations to develop a strategy document which “align[s] educational goals with the care needs of patients progressing through an integrated healthcare system”. 36 Their strategy is underpinned by a shared vision, patient-centered goals and a holistic, multidisciplinary approach.…”

Section: Development and Implementation Of Integrated Care Pathways–opportunities And Barriersmentioning

confidence: 99%

“…This has been demonstrated by BSACI who recently formed an Allergy Education Network, 36 comprising of a range of HCPs from different settings, clinical academics, and representatives from patient support organizations to develop a strategy document which “align[s] educational goals with the care needs of patients progressing through an integrated healthcare system”. 36 Their strategy is underpinned by a shared vision, patient-centered goals and a holistic, multidisciplinary approach. Detailed discussion of education which commences during undergraduate and primary training of all healthcare professionals is presented in a separate paper.…”

Section: Development and Implementation Of Integrated Care Pathways–opportunities And Barriersmentioning

confidence: 99%

“…The complexity of allergy as a chronic condition demands an emphasis on patient-centered practice to optimize physical and mental well-being and prevent adverse outcomes. 36 To this end, it is vital to develop core professional competences for AHPs working in allergy care, and to ensure MDT members are aware of their respective roles and responsibilities. Fig.…”

Section: Multidisciplinary Roles In the Allergy Integrated Care Pathwaymentioning

confidence: 99%

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Harmonizing allergy care–integrated care pathways and multidisciplinary approaches

Daniels

Barker

Chang

et al. 2021

World Allergy Organization Journal

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There is a wide time gap between the publication of evidence and the application of new knowledge into routine clinical practice. The consequence is sub-optimal outcomes, particularly concerning for long-term relapsing/remitting conditions such as allergic diseases. In response, there has been a proliferation of published guidelines which systematically review evidence for the gold-standard management of most allergic disorders. However, this has not necessarily been followed by improved outcomes, partly due to a lack of coordination across the patient pathway. This has become known as the "second translational gap". A proposed solution is the development and implementation of integrated care pathways (ICPs) to optimize patient outcomes, with the notion that evidence-based medicine requires evidence-based implementation. ICP implementation is shown to improve short-term outcomes for acute conditions and routine surgery, including reduced length of hospital stay, improved documentation and improved patient safety. However, this improvement is not reflected in patient experience or patient-centered functional outcomes. The implementation of life-long, cost-effective interventions within comprehensive pathways requires a deep appreciation for complexity within allergy care. We promote an evidence-based methodology for the implementation of ICPs for allergic disorders in which all stakeholders in allergy care are positioned equally and encouraged to contribute, particularly patients and their caregivers. This evidence-based process commences with scoping the unmet needs, followed by stakeholder mapping. All stakeholders are invited to meetings to develop a common vision and mission through the generation of action/effect diagrams which helps build concordance across the agencies. Dividing the interventions into achievable steps and reviewing with plan/do/study/act cycles will gradually modify the pathway to achieve the best outcomes. While the management guidelines provide the core knowledge, the key component of implementation involves education, training, and support of all healthcare professionals (HCPs), patients and their caregivers. The pathways should define the level of competence required for each clinical task. It may be useful to leave the setting of care delivery or the specific HCP involved undefined to account for variable patterns of health service delivery as well as local socioeconomic, ethnic, environmental, and political imperatives. In all cases, where competence is exceeded, it is necessary to refer to the next stage in the pathway. The success and sustainability of ICPs would ideally be judged by patient experience, health outcomes, and health economics. We provide examples of successful programs, most notably from Finland, but recommend that further research is required in diverse settings to optimize outcomes worldwide.

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Mixed‐methods evaluation of a nurse‐led allergy clinic model in primary care: Feasibility trial

Hammersley

Kelman

Morrice

et al. 2022

Clinical & Translational All

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Introduction:It is now widely acknowledged that there are serious shortcomings in allergy care provision for patients seen in primary care. We sought to assess the feasibility of delivering and evaluating a new nurse-led allergy service in primary care, measured by recruitment, retention and estimates of the potential impact of the intervention on disease-specific quality of life.Methods: Mixed-methods evaluation of a nurse-led primary care-based allergy clinic in Edinburgh, UK undertaken during the period 2017-2021 with a focus on suspected food allergy and atopic eczema in young children, allergic rhinitis in children and young people, and suspected anaphylaxis in adults. Prior to March 2020, patients were seen face-to-face (Phase 1). Due to COVID-19 pandemic restrictions, recruitment was halted between March-August 2020, and a remote clinic was restarted in September 2020 (Phase 2). Disease-specific quality of life was measured at baseline and 6-12 weeks post intervention using validated instruments. Quantitative data were descriptively analysed. We undertook interviews with 16 carers/patients and nine healthcare professionals, which were thematically analysed. Results:During Phase 1, 426/506 (84%) referred patients met the eligibility criteria; 40/46 (87%) of Phase 2 referrals were eligible. Males and females were recruited in approximately equal numbers. The majority (83%) of referrals were for possible food allergy or anaphylaxis. Complete data were available for 338/ 426 (79%) patients seen in Phase 1 and 30/40 (75%) in Phase 2. Compared with baseline assessments, there were improvements in disease-specific quality of life for most categories of patients. Patients/carers and healthcare professionals reported high levels of satisfaction, this being reinforced by the qualitative interviews in which convenience and speed of access to expert opinion, the quality of the consultation, and patient/care empowerment were particularly emphasised.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Time to act to solve gaps in practice: The BSACI National Allergy Education Strategy

Cited by 5 publications

References 8 publications

BSACI national allergy education strategy for healthcare professionals

BSACI national allergy education strategy for healthcare professionals

Harmonizing allergy care–integrated care pathways and multidisciplinary approaches

Mixed‐methods evaluation of a nurse‐led allergy clinic model in primary care: Feasibility trial

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