• Can emergency care practitioners differentiate between an avoided emergency department attendance and an avoided admission?

      Coates, David; Rawstorne, Steven; Benger, Jonathan (2012-10)
      After a 999 call to the ambulance service, there is no ‘gold standard’ for determining whether the actions of an emergency care practitioner (ECP) result in a patient avoiding attendance at an emergency department (ED) or avoiding an admission to hospital. Within the Great Western Ambulance Service NHS Trust this outcome has previously been measured using an audit form completed by the ECP. However, the accuracy of the ECP's opinion has not been assessed. https://emj.bmj.com/content/29/10/838.long 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. http://creativecommons.org/licenses/by-nc/4.0/ DOI http://dx.doi.org/10.1136/emermed-2011-200484
    • ECPs: avoiding emergency department attendance or hospital admission?

      Coates, David (2010-04)
      The aim of the literature review was to identify and appraise studies that have compared the effectiveness and decision-making of emergency care practitioners with other health professionals. There is no ‘gold standard’ for determining whether the actions of an emergency care practitioner (ECP) results in a patient avoiding attendance at an emergency department (ED) or hospital admission. Consequently, reporting on the cost effectiveness of ECPs is potentially spurious, especially as the cost difference between ED attendance and hospital admission is considerable. Medline and EMBASE databases were searched for publications relevant to the study area. Additional searches were carried out using the online search function offered by the Cochrane Library and the Emergency Medicine Journal. Twenty-nine publications met the inclusion criteria. Nineteen of these papers were considered suitable for background information only. Ten studies were analyzed in further detail and three main themes identified: non-conveyance rates, decision-making and admission avoidance. Studies show that patients assessed by ECPs are less likely to be conveyed to the ED, than when attended by a traditional ambulance response. The Department of Health (DH, 2005) refer to a traditional ambulance service response to a 999 call as sending a double-crewed paramedic ambulance to the patient, provide any necessary life support to stabilize the patient and transport to the ED. The decision-making of ECPs compares favourably with other health professionals when deciding whether a patient can be treated at home, or requires ED attendance or hospital admission. No studies were found that determined whether an ECP is able to accurately decide whether their intervention results in patients avoiding ED attendance or admission. There is a need to evaluate the validity of data collection methods which differentiate between emergency department and admission avoidance as a result of the actions of ECPs. Abstract published with permission.
    • How to improve patient care by learning from mistakes

      Brady, Dr Mike (2013-02)
      Mistakes made in healthcare settings and the challenges to staff that arise from them can harm service users, consume time and money, and often receive bad publicity. However, by learning from these mistakes and meeting these challenges, practitioners can improve the quality of the care they provide. This article explores what is meant by mistakes and challenges in the context of health care. It suggests that front line managers are best placed to prevent and learn from mistakes, and thereby improve care for patients. https://search.proquest.com/docview/1314303097/fulltextPDF/1B3083DD1AA04444PQ/1?accountid=48092 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. http://creativecommons.org/licenses/by-nc/4.0/ DOI http://dx.doi.org/10.7748/en2013.02.20.9.32.e679