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dc.contributor.authorKirby, Oliver
dc.contributor.authorGreenhalgh, Rob
dc.contributor.authorGoodsman, Dane
dc.contributor.authorDavies, Gareth
dc.date.accessioned2021-05-22T14:25:02Z
dc.date.available2021-05-22T14:25:02Z
dc.identifier.citationJoy, T. et al, 2019. Community emergency medicine: taking the ED to the patient: a 12-month observational analysis of activity and impact of a physician response unit. Emergency Medicine Journal, emermed-2018-208394.en_US
dc.identifier.issn1472-0213
dc.identifier.issn1472-0205
dc.identifier.doi10.1136/emermed-2018-208394
dc.identifier.urihttp://hdl.handle.net/20.500.12417/1103
dc.description.abstractInternational and national health policies advocate greater integration of emergency and community care. The Physician Response Unit (PRU) responds to 999 calls 'taking the Emergency Department to the patient'. Operational since 2001, the service was reconfigured in September 2017. This article presents service activity data and implications for the local health economy from the first year since remodelling. METHODS: A retrospective descriptive analysis of a prospectively maintained database was undertaken. Data collected included dispatch information, diagnostics and treatments undertaken, diagnosis and disposition. Treating clinical teams recorded judgments whether patients managed in the community would have been (1) conveyed to an emergency department (ED)and (2) admitted to hospital, in the absence of the PRU. Hospital Episode Statistics data and NHS referencing costs were used to estimate the monetary value of PRU activity. RESULTS: 1924 patients were attended, averaging 5.3 per day. 1289 (67.0%) patients were managed in the community. Based on the opinion of the treating team, 945 (73.3%) would otherwise have been conveyed to hospital, and 126 (9.7%) would subsequently have been admitted. The service was estimated to deliver a reduction of 868 inpatient bed days and generate a net economic benefit of £530 107. CONCLUSIONS: The PRU model provides community emergency medical care and early patient contact with a senior clinical decision-maker. It engages with community providers in order to manage 67.0% of patients in the community. We believe the PRU offers an effective model of community emergency medicine and helps to integrate local emergency and community providers., https://www.ncbi.nlm.nih.gov/pubmed/31857371. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ DOI: 10.1136/emermed-2018-208394
dc.language.isoenen_US
dc.subjectPre-hospital Careen_US
dc.subjectCommunity Networksen_US
dc.subjectEmergency Departmenten_US
dc.subjectPhysician Response Uniten_US
dc.titleCommunity emergency medicine: taking the ED to the patient: a 12-month observational analysis of activity and impact of a physician response uniten_US
dc.source.journaltitleEmergency Medicine Journalen_US
rioxxterms.versionNAen_US
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden_US
rioxxterms.licenseref.startdate2020-02-12
rioxxterms.typeJournal Article/Reviewen_US
refterms.panelUnspecifieden_US
refterms.dateFirstOnline2019-12-19
html.description.abstractInternational and national health policies advocate greater integration of emergency and community care. The Physician Response Unit (PRU) responds to 999 calls 'taking the Emergency Department to the patient'. Operational since 2001, the service was reconfigured in September 2017. This article presents service activity data and implications for the local health economy from the first year since remodelling. METHODS: A retrospective descriptive analysis of a prospectively maintained database was undertaken. Data collected included dispatch information, diagnostics and treatments undertaken, diagnosis and disposition. Treating clinical teams recorded judgments whether patients managed in the community would have been (1) conveyed to an emergency department (ED)and (2) admitted to hospital, in the absence of the PRU. Hospital Episode Statistics data and NHS referencing costs were used to estimate the monetary value of PRU activity. RESULTS: 1924 patients were attended, averaging 5.3 per day. 1289 (67.0%) patients were managed in the community. Based on the opinion of the treating team, 945 (73.3%) would otherwise have been conveyed to hospital, and 126 (9.7%) would subsequently have been admitted. The service was estimated to deliver a reduction of 868 inpatient bed days and generate a net economic benefit of £530 107. CONCLUSIONS: The PRU model provides community emergency medical care and early patient contact with a senior clinical decision-maker. It engages with community providers in order to manage 67.0% of patients in the community. We believe the PRU offers an effective model of community emergency medicine and helps to integrate local emergency and community providers., https://www.ncbi.nlm.nih.gov/pubmed/31857371. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ DOI: 10.1136/emermed-2018-208394en_US
dc.contributor.nonasauthorJoy, Tony
dc.contributor.nonasauthorRamage, Lisa
dc.contributor.nonasauthorMitchinson, Sophie


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