Acute respiratory infection in over 16s: initial assessment and management including virtual wards (hospital at home)

Process

a) Proportion of discharges from an acute respiratory infection virtual ward where a discharge summary including follow‑up details is given to the person.

Numerator – the number in the denominator where a discharge summary including follow‑up details is given to the person.

Denominator – the number of discharges from an acute respiratory infection virtual ward.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient records.

b) Proportion of discharges from an acute respiratory infection virtual ward where a discharge summary including follow‑up details is shared with the person's GP.

Numerator – the number in the denominator where a discharge summary including follow‑up details is shared with the person's GP.

Denominator – the number of discharges from an acute respiratory infection virtual ward.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient records.

Outcome

Proportion of adults discharged from an acute respiratory infection virtual ward who knew what would happen next with their care.

Numerator – the number in the denominator who knew what would happen next with their care.

Denominator – the number of adults discharged from an acute respiratory virtual ward.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient surveys.

Acute respiratory infection virtual ward

These support personalised care for people with confirmed or suspected acute respiratory infections, including COVID‑19 and non-infective chronic obstructive pulmonary disease exacerbations, who are stable or improving but require acute level care and choose to be cared for at home. They do this by providing an alternative to a hospital admission and/or to support safe early discharge from hospital for people who require ongoing hospital monitoring and treatment. They require a combination of face-to-face care and digital technology in the place a person calls home, including care homes. [Adapted from NHS England's guidance note on virtual ward care for people with acute respiratory infection including chronic obstructive pulmonary disease, introduction section]

Discharge summary, including follow-up details

This should include confirmation of diagnosis and details of any antimicrobials prescribed, and facilitate further investigations, if indicated, and appropriate follow‑up (preferably in other community services where appropriate.) This could include pharmacy-led new medication reviews for adults started on inhalers, follow‑up chest X‑ray for adults with community-acquired and COVID‑19 pneumonia, referral to vaccination services and smoking cessation follow-up. Where a comprehensive geriatric assessment, chronic obstructive pulmonary disease bundle or advance care plan has been started this must be clearly communicated. The person should be given clear safety netting advice that includes instructions on how to seek help if they feel unwell on discharge. [NHS England's guidance note on virtual ward care for people acute respiratory infection including chronic obstructive pulmonary disease, appendix on acute respiratory infection pathway – stage 4 recovery and discharge; GIRFT and NHS England's making the most of virtual wards, including hospital at home (2023), acute respiratory infection – cohorts and optimisation; and expert opinion]