The management of children in unscheduled care services by emergency care practitioners

2010 ◽  
Vol 27 (Suppl 1) ◽  
pp. A8.2-A8
Author(s):  
Colin O'Keefe
Keyword(s):  
Emergency Care ◽  
Urgent Care ◽  
Health Providers ◽  
Out Of Hours ◽  
Randomised Study ◽  
Care Services ◽  
Unscheduled Care ◽  
Discharge Rates ◽  
The Difference ◽  
A Minor

Background/objectivesEmergency Care Practitioners (ECPs) are an example of a new role in healthcare. ECPs are substituting for standard providers such as doctors in various unscheduled care services. In these services ECPs are managing paediatric cases, although there is no evidence for their effective management of this patient group. As part of a multi-centre trial we evaluated ECP effectiveness in the discharge of children following a minor illness or injury care episode.MethodsThree pairs of unscheduled services (urgent care, minor injury unit and out of hours) were included in the trial. Each pair comprised an intervention ECP service and a matched control service employing standard non-ECP providers. All care episodes of patients under the age of 16 were identified from the three pairs of services. The primary outcome was percentage of patients discharged after consultation.ResultsAcross all services the percentage of patients discharged by ECPs was significantly less than the percentage discharged by standard non-ECP providers (59% vs 66%; X2 = 10.1; df=1; p<0.05). ECPs discharged fewer patients in all three pairs of services and in the Out of Hours (X2=4.1; df=1; p< 0.05) and the Urgent Care Centre (X2=4.7; df=1; p<0.05) pairs the difference in discharge rates was statistically significant.ImplicationsECPs do not appear to be as effective as standard health providers in discharging children after care. ECPs may be better targeted at patients groups in which there is better evidence of their effectiveness.LimitationsFindings for these services individually may not be generalisable to other similar service settings. However, nationally, the participating services were not considered atypical in how ECP services had developed. It was not possible to design a randomised study in the context of ECP working because the services were already operational.

Perceptions of emergency medicine and acute care among a cohort of non-emergency medicine health providers in Myanmar

2019 ◽  
Author(s):  
Corey B. Bills ◽  
Peter Acker ◽  
Tina McGovern ◽  
Rebecca Walker ◽  
Htoo Ohn ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Acute Care ◽  
Emergency Care ◽  
Healthcare Providers ◽  
Unmet Need ◽  
Health Providers ◽  
Care Providers ◽  
Convenience Sample ◽  
Care Services ◽  
Acute Care Services

Abstract Background Currently, Myanmar does not have a nationalized emergency care or emergency medical services (EMS) system. The provision of emergency medicine (EM) education to physicians without such training is essential to address this unmet need for high quality emergency care. We queried a group of healthcare providers in Myanmar about their experience, understanding and perceptions regarding the current and future needs for EM training in their country. Methods A 34-question survey was administered to a convenience sample of healthcare workers from two primary metropolitan areas in Myanmar to assess exposure to and understanding of emergency and pre-hospital care in the country. Results 236 of 290 (81% response rate) individuals attending one of two full-day symposia on emergency medicine completed the survey. The majority of respondents were female (n=138, 59%), physicians (n=171, 74%), and working in private practice (n=148, 64%). A majority of respondents (n=133, 57%) spent some to all of their clinical time providing acute and emergency care however 83.5% (n=192) of all surveyed reported little or no past training in emergency care; and those who have received prior emergency medicine training were more likely to care for emergencies (>2 weeks training; p=.052). 81% (n= 184) thought the development of emergency and acute care services should be a public health priority. Conclusions Although this subset of surveyed health practitioners commonly provides acute care, providers in Myanmar may not have adequate training in emergency medicine. Continued efforts to train Myanmar’s existing healthcare workforce in emergency and acute care should be emphasized.

scholarly journals Co-location of Out of Hours Primary Care and Emergency Department in Belgium: Patients’ and Physicians’ View

2020 ◽  
Author(s):  
Birgitte Schoenmakers ◽  
Jasper Van Criekinge ◽  
Timon Boeve ◽  
Jonas Wilms ◽  
Chris Van Der Mullen ◽  
...  
Keyword(s):  
Emergency Care ◽  
Emergency Service ◽  
Care Quality ◽  
Successful Implementation ◽  
Emergency Physicians ◽  
Out Of Hours ◽  
Information Campaigns ◽  
Care Services ◽  
High Care ◽  
Section Design

Abstract Background In Belgium, General Practitioner Cooperatives (GPC) aim to improve working conditions for unplanned care and to reduce the number of inappropriate emergency visits. Although this system is well organised, the number of inappropriate visits does not decrease. Methods We explored the position of patients and physicians on the co-location of a GPC and an emergency service for unplanned care. The study was carried out in a cross section design in primary and emergency care services, including patients and physicians. Main outcome measures were the position of patients and physician on co-location a GPC and an emergency service. Results 404 patients and 488 physicians participated. 334 (82.7%) of all patients favored a co-location. The most important advantages were fast service (104, 25.7) and adequate referral (54, 13.4%). 237 (74%) of the GP’s and 38 (95%) of the emergency physicians were in favor of a co-location. The major advantage of this system was a more adequate referral of patients. 254 (79%) of the GP’s and 23 (83%) of the emergency physicians believed that a co-location would lower the workload, decrease waiting time and increase care quality (resp. 251 (78%), 224 (70%) and 37 (93%), 34 (85%). Conclusions To meet all concerns and to reach for high care quality information campaigns and development of workflows are necessary for a successful implementation of a co-location of primary and emergency care.

A distributed and interoperable system for out-of-hours health care

2007 ◽  
Vol 13 (1_suppl) ◽  
pp. 24-25
Author(s):  
Mario Fregonara Medici
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Health District ◽  
Urgent Care ◽  
Call Centre ◽  
Medical Support ◽  
Care Needs ◽  
Out Of Hours ◽  
Care Services ◽  
Care Problems

In Italy, at nights and weekends, there is an out-of-hours service called the Continuity Healthcare Service (CHS) which provides for urgent, non-emergency health-care needs. The CHS manages the following typical requests: information on health-care services, support and assistance, prescriptions, various kinds of clinical advice, urgent care problems, general practitioners’ visits and suspected emergencies which require immediate evaluation. A distributed and interoperable system (DAISIES) was proposed to manage the entire CHS process for each health district, with particular emphasis on health assistance, medical support and urgent care problems. The DAISIES system is now being implemented in a health district in the northern part of Milan, with the implementation of a service call-centre and some first-aid stations. Experience to date shows that it is possible to implement a technology-based model for the organization and the management of an out-of-hours health service, with particular emphasis on health assistance, medical support and urgent care problems.

scholarly journals Accessibility to urgent and emergency care services in low-density territories: the case of Baixo Alentejo, Portugal

2021 ◽  
Vol 26 (suppl 1) ◽  
pp. 2483-2496
Author(s):  
Rita Ferreira ◽  
Nuno Marques da Costa ◽  
Eduarda Marques da Costa
Keyword(s):  
Population Density ◽  
Emergency Care ◽  
Low Income ◽  
Access To Health Care ◽  
Emergency Services ◽  
Urgent Care ◽  
Medical Emergency ◽  
Care Services ◽  
Time Distance ◽  
Emergency Care Services

Abstract Access to health care is a sensitive issue in low population density territories, as these areas tend to have a lower level of service provision. One dimension of access is accessibility. This paper focuses on measuring the accessibility to urgent and emergency care services in the Portuguese region of Baixo Alentejo, a territory characterized by low population density. Data for the calculation of accessibility is the road network, and the methodology considers the application of a two-level network analyst method: time-distance by own mean (car or taxi) to the urgent care services and the time distance to emergency services as a way to get assistance and to go to urgent care services. While urgent care accessibility meets the requirements stipulated in the Integrated Medical Emergency System’s current legislative framework, the simulation of different scenarios of potential accessibility shows intra-regional disparities. Some territories have a low level of accessibility. Older adults, the poorly educated, and low-income population, also have the lowest levels of accessibility, which translates into dually disadvantageous situation since the potential users of emergency services are most likely to belong to this group of citizens.

Effective safety netting in acute childhood illness: an important contribution to avoiding preventable deaths

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X696893
Author(s):  
Sarah Neill ◽  
Damian Roland ◽  
Matthew Thompson ◽  
Sue Palmer-Hill ◽  
Natasha Bayes ◽  
...  
Keyword(s):  
Research Programme ◽  
Safety Net ◽  
Childhood Illness ◽  
Urgent Care ◽  
Video Capture ◽  
Delivery Modes ◽  
Care Services ◽  
The Right ◽  
Qualitative Exploration ◽  
Safety Netting

BackgroundChildren’s use of urgent care services continues to increase. If families are to access the right services at the right time they need access to information to inform their decision making. Providing a safety net of information has the potential to reduce morbidity and avoidable mortality and has been shown to reduce re-consultation safely.AimOur research programme aims to provide parents with information they can use to help them determine when to seek help for an acutely ill child.MethodOur programme includes: ASK SARA, a systematic review of existing interventions; ASK PIP, qualitative exploration of safety netting information used by parents and professionals; ASK SID, development of the content and delivery modes for the intervention; ASK ViC, video capture of children with acute illness; and ASK Petra, safety netting tool development using consensus methodology.ResultsThe ASK SNIFF programme findings demonstrate the need for professionally endorsed and co-produced safety netting resources focussing on symptoms of acute childhood illness. We now have consensus on the scripted content for a safety netting tool supported by video materials to enable parents to see symptoms for real.ConclusionSafety netting tools are a valuable aid to general practice enabling GPs to show parents what to look out for when their child is sick so that they know when to (re)consult. Recent reports of failure to recognise and appropriately safety net children with sepsis highlights the importance of such tools.

scholarly journals Delivering Community Emergency Medicine during the COVID-19 pandemic: the Physician Response Unit

2021 ◽  
Vol 38 (5) ◽  
pp. 371-372
Author(s):  
Rich Carden ◽  
Bill Leaning ◽  
Tony Joy
Keyword(s):  
Emergency Medicine ◽  
Emergency Care ◽  
Hospital Admissions ◽  
Hospital Setting ◽  
Response Unit ◽  
Care Services ◽  
Vulnerable Patients ◽  
Palliative Care Services ◽  
Alternative Solutions ◽  
Physician Response

The COVID-19 pandemic has presented significant challenges to services providing emergency care, in both the community and hospital setting. The Physician Response Unit (PRU) is a Community Emergency Medicine model, working closely with community, hospital and pre-hospital services. In response to the pandemic, the PRU has been able to rapidly introduce novel pathways designed to support local emergency departments (EDs) and local emergency patients. The pathways are (1) supporting discharge from acute medical and older people’s services wards into the community; (2) supporting acute oncology services; (3) supporting EDs; (4) supporting palliative care services. Establishing these pathways have facilitated a number of vulnerable patients to access patient-focussed and holistic definitive emergency care. The pathways have also allowed EDs to safely discharge patients to the community, and also mitigate some of the problems associated with trying to maintain isolation for vulnerable patients within the ED. Community Emergency Medicine models are able to reduce ED attendances and hospital admissions, and hence risk of crowding, as well as reducing nosocomial risks for patients who can have high-quality emergency care brought to them. This model may also provide various alternative solutions in the delivery of safe emergency care in the postpandemic healthcare landscape.

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