• Can emergency medical service staff predict the disposition of patients they are transporting?

      Clesham, K.; Mason, S.; Gray, J.; Walters, S.; Cooke, V. (2008-10-08)
      Emergency medical service (EMS) staff in the UK routinely transport all emergency responses to the nearest emergency department (ED). Proposed reforms in the ambulance service mean that EMS staff will transport patients not necessarily to the nearest hospital, but to one providing facilities that the patient is judged to require. No previous UK studies have evaluated how accurately EMS staff can predict which transported patients will require admission to hospital. https://emj.bmj.com/content/25/10/691 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/emj.2007.054924
    • Pilot evaluation of utilising mental health nurses in the management of ambulance service patients with mental health problems

      Irving, Andy; O'Hara, Rachel; Johnson, Maxine; Harris, Angela; Baker, Kieran (2016-09)
      Background The urgent and emergency care review advocates new models of care to provide safer, faster and better care. Available evidence highlights scope for improvement in the delivery of care for patients calling 999 with mental health problems. The purpose of this abstract is to describe an ongoing initiative in Yorkshire Ambulance Service utilising specialist triage by mental health nurses in the Emergency Operations Centre (EOC) since December 2014. Methods An exploratory mixed methods evaluation was conducted. Interviews (n=12) with key stakeholders in the ambulance service were conducted to explore their experiences of service provision for patients with mental health problems and the impact of introducing Mental Health Nurse triage in the EOC. Interview data was coded and thematically analysed to identify key issues around service delivery for patients with mental health problems. Routine data from ambulance service computer aided dispatch was used to examine impact on patient care and resource allocation. Results Initial findings indicate that access to mental health nurses in the EOC reduced the ambulance response rate by clinically triaging calls for patients with mental health problems and only sending a resource where appropriate. Staff interviews revealed the developmental process and challenges involved in implementing the mental health triage initiative, for example, recruitment, training and governance. Staff perceptions of the initial positive impact of the mental health nurses include the delivery of more appropriate patient care and reduced anxiety for staff managing calls that now have access to specialist support. Conclusions Despite the relatively short time period since the inception of this initiative, the preliminary findings from this pilot evaluation suggest a positive impact on service delivery from a patient and organisational perspective. Lessons learned from the implementation of this initiative and its progression are potentially informative for other Ambulance Service Trusts considering adopting a similar approach. https://emj.bmj.com/content/emermed/33/9/677.2.full.pdf 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 http://dx.doi.org/10.1136/emermed-2016-206139.2
    • A project to improve system performance and patient flow in the emergency operations centre in identification of high risk silver trauma service users who have suffered a traumatic head injury

      Faqir, Islam (2018-07-01)
      Major trauma or MT has historically and traditionally been associated as a disease mainly affecting young men, normally under the age of 401 (NAO 2010). Major trauma describes serious and often multiple injuries where there is a strong possibility of death or disability2 (Keogh et al. 2015). Nationally the population is growing older, it is anticipated that the elderly will form an increasing part of the major trauma work load. A recent report published by TARN3 2017, found that elderly trauma currently accounts for 20% of patients, the predominant reason was a fall from <2 metres. The Emergency Operations Centre or EOC reported call demand for the year ending 2016 was 8 55 015 (YAS BI, 2017). All calls receive a code dependent on chief complaint calls that coded 17 (falls) accounted for 82 847 of that call volume, just under 7000 calls a month. Calls that code 17 (green) has the potential of a 90 delay in call back from a clinician at times this can be prolonged further dependent on call demand within the EOC. https://stel.bmj.com/content/4/Suppl_1/A10.1. 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 http://dx.doi.org/10.1136/bmjstel-2018-heeconf.15