Cooke, Matthew, MB ChB, Fisher, Joanne, Dale, Jeremy, 1958-, McLeod, Eileen, Szczepura, Ala, Walley, Paul and Wilson, Sue, Dr (2004) Reducing attendances and waits in emergency departments : a systematic review of present innovations. [London]: [National Co-ordinating Centre for NHS Service Delivery and Organisation R & D (NCCSDO)]. ( ).

Preview

PDF WRAP_Szczepura_29-final-report.pdf - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader Download (659Kb)

Abstract

Reducing the waits in emergency departments is important for patients and is a government priority. In order to reduce waits the whole system must be considered. The flow of patients before arrival at the emergency department determines the workload of the department. The staffing, resources and systems within the emergency department are key to providing high quality timely care. The flow of patients after leaving the emergency department until their return home will determine whether they can be discharged from the department in a timely manner. Despite the present focus on emergency care in the NHS there have been no reviews of the literature to inform the present changes to reduce waits.

Item Type:	Report
Subjects:	R Medicine > R Medicine (General)
Divisions:	Faculty of Medicine > Warwick Medical School > Clinical Sciences Research Institute (CSRI) Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Hospitals -- Emergency services
Series Name:
Publisher:	[National Co-ordinating Centre for NHS Service Delivery and Organisation R & D (NCCSDO)]
Place of Publication:	[London]
Date:	January 2004
Number of Pages:	252
Status:	Not Peer Reviewed
Access rights to Published version:	Open Access
Description:	Final version (as published).
Funder:	NHS Service Delivery and Organisation R&D Programme
Grant number:	SDO/29/2002
References:	Airey, D. and Franks, A.J. 1995. ‘Major trauma workload within an English health region’, Injury 26: 25–31. Allerman, G,, McKay, J,I, and Novotny-Dinsdale, V. 1985. ‘Use of prehospital care providers in emergency departments: A national survey’, Journal of Emergency Nursing 11:33-9. American College of Emergency Physicians. [n.d.]. The ACEP have produced a range of best practice resources, available online [March 2005] at www.acep.org/webportal/PracticeResources/ Allerston, J. and Justham, D. 2000. ‘A case-control study of the transit times through an accident and emergency department of ankle injured patients assessed using the Ottawa Ankle Rules’, Accident and Emergency Nursing 8:148-154. Anderson, S., Hogskilde, P.D., Wettersley, J., Bredgaard, M., Sorensed, Moller, J.T., Dahl, J.B., Hogskilde, S. 2002. ‘Appropriateness of leaving emergency medical service treated hypoglycemic patients at home: a retrospective study’, Acta Anaesthesiologica Scandinavica 46:464-468. Andersson, G. and Karlberg, I. 2001. ‘Lack of integration, and seasonal variations in demand explained performance problems and waiting times for patients at emergency departments: a three year evaluation of the shift of responsibility between primary and secondary care by closure of two acute hospitals’, Health Policy 55:187-207. Andren, K.G. and Rosenquvist, U. 1985. ‘Heavy users of an emergency department: psycho-social and medical characteristics, other health care contacts and the effect of a hospital social worker intervention’, Social Science and Medicine 21:761-770. [Anon]. 1998a. ‘These novel strategies decrease ED delays’, RN 61:24. [Anon]. 1998b. ‘Data from ED patient tracking system help identify xray cycle time improvements’, Data Strategies and Benchmarks 2:4-8. [Anon]. 1998c. ‘Diabetes program cuts ED visits 67% in first 6 months’, Disease State Management 4:16-17. [Anon]. 1999. ‘Albuquerque halts EMS triage program’, EMS Insider 8. [Anon]. 2000a. ‘Creating new emergency center registration process improves patients’ satisfaction with time from arrival to treatment’, Joint Commission Benchmark 2:6-7. [Anon]. 2000b. ‘Teamwork helps cut ED wait times’, Healthcare Benchmarks7:40-41. Reducing Attendances and Waits in Emergency Departments © NCCSDO 2005 200 Anthony, M. and Dunne, M.O. 1997. ‘The appropriateness of A&E attendances: A prospective study’, The Irish Medical Journal 90:268-269. Ardagh, M.W., Wells, J.E., Cooper, K., Lyons, R., Patterson, R. and O’Donovan, P. 2002. ‘Effect of a rapid assessment clinic on the waiting time to be seen by a doctor and the time spent in the department, for patients presenting to an urban emergency department: A controlled prospective trial’, New Zealand Medical Journal 115: U28. Arizona College of Emergency Physicians. 2000. Emergency department crowding & ambulance diversion. Arizona: Arizona College of Emergency Physicians. Armstrong, A.M., Pennycook, A.G., Swann, I.J. 1991. ‘Unplanned reattendance in the accident and emergency department’, Scottish Medical Journal 36:111-114. Armstrong, S.H., Peden, N.R., Nimmo, S. and Alcorn, M. 2001. ‘Appropriateness of bed usage for inpatients admitted as emergencies to internal medicine services’, Health Bulletin 59:388- 395. Askenasi, R., Lheureux, P. and Gillet, J.B. 1989. ‘Influence of tests on patient time in the emergency department’, Reanimation Soins Intensifs Medecine d’Urgence 5:201-202. Asplin, B.R. 2001. ‘Undertriage, overtriage or no triage?’, Annals of Emergency Medicine 38:282-285. Audit Commission. 1996. By Accident or Design: Improving A&E Services in England and Wales. London: HMSO. Audit Commission. 1998. By Accident or Design: A review of progress in A&E. London: HMSO. Audit Commission. 2001. By Accident or Design: Improving A&E Services in England and Wales. London: HMSO. Audit Commission. 2003. Acute hospital portfolio: Bed management. [Online]. Available (March 2005) at www.healthcarecommission.org.uk/assetRoot/04/00/02/38/040002 38.pdf. Azzazy, H.M.E. and Christenson, R.H. 2002. ‘Cardiac markers and point of care testing: A practical approach’, Journal of Clinical Ligand Assay 25:325. Badgett, J.T. 1986. ‘Can Medicaid format alter emergency department utilization patterns?’, Pediatric Emergency Care. 2:67-70. Bagust, A., Place, M., and Posnett, J.W. 1999. ‘Dynamics of bed use in accommodating emergency admissions: stochastic simulation model’, British Medical Journal 319:155. Baker, D.W., Parker, R.M., Williams, M.V., Scott Clark, W. 1998. ‘Health literacy and the risk of hospital admission’, Journal of General Internal Medicine 13:791-798. Reducing Attendances and Waits in Emergency Departments © NCCSDO 2005 201 Baker, D.W., Stevens, C.D. and Brook, R.H. 1996. ‘Determinants of emergency department use: are race and ethnicity important?’, Annals of Emergency Medicine 28:677. Ball, J., Dixon, M. and Holt, L. 2000. ‘Why are we waiting? Snapshots surveys of the impact of emergency pressures on patient care’, Emergency Nurse 8:22-27. Banerjee, S. and Rhoden, W.E. 1998. ‘Fast-tracking of myocardial infarction by paramedics’, Journal of the Royal College of Physicians 32:36-8. Baraff, L.J., Lee, T.J., Kader, S. and Della-Penna, R. 1999. ‘Effect of a practice guideline for emergency department care of falls in elderly patients on subsequent falls and hospitalisations for injuries’, Academic Emergency Medicine 6:1224-31. Bayley, M., Schwartz, J. Shofer, F., Weiner, M., Sites, F., Traber, K. and Hollander, J. 2002. ‘The financial burden of ED congestion and hospital overc rowding for chest pain patients awaiting admission’, Academic Emergency Medicine 9:367-a. Bazarian, J.J., Schneider, S.M., Newman, V.J. and Chodosh, J. 1996. ‘Do admitted patients held in the emergency department impact the throughput of treat-and-release patients?’, Academic Emergency Medicine 3:1113-1118. Beales, J. 1997. ‘Innovation in Accident and Emergency management: establishing a nurse practitioner-run minor/ injuries/primary care unit’, Accident and Emergency Nursing 5:71-75. Beecham, L. 1999. ‘Accident departments are not used properly’, British Medical Journal 318:1293. Benavent, A.V. and Casares, R.F. 1994. ‘Primary care as a determinant of the utilization of hospital emergency services’, Atencion Primaria 14:825-828. Beney, J., Bero, L.A. and Bond, C. 2001. ‘Expanding the roles of outpatient pharmacists: effects on health services utilisation, costs, and patient outcomes. (Cochrane Review)’, in The Cochrane Library, Issue 4. Chichester, UK: John Wiley & Sons, Ltd. Benz, J.R. and Shank, J.C. 1982. ‘Alteration of emergency room usage in a family practice residency programme’, Journal of Family Practice 15:1135-1139. Birnbaum, A,, Gallagher, E.J., Utkewicz, M., Gennis, P. and Carter, W. 1994. ‘Failure to validate a predictive model for refusal of care to ED patients’, Academic Emergency Medicine 1:213-217. Blaivas, M., Sierzenski, P., Plecque, D. and Lambert, M. 2000. ‘Do emergency physicians save time when locating a live intrauterine pregnancy with bedside ultrasonography?’, Academic Emergency Medicine. 7:988-993. Reducing Attendances and Waits in Emergency Departments © NCCSDO 2005 202 Blanco, A., Pileggi, C. and Angelillo, I.F. 2003. ‘Non urgent visits to a hospital emergency department in Italy’, Public Health 117:250- 255. Bloe, C. 2001. ‘Nurse-initiated coronary thrombolysis’, Nursing Times 97:40-42. Bluth, E.I., Lambert, D.J. and Lohmann, T.P. 1992. ‘Improvements in “stat” laboratory turn-around time. A model continuous quality improvement project’, Archives of Internal Medicine 152:837-840. Boaden, R., Proudlove, N. and Wilson, M. 1999. ‘An exploratory study of bed management’, Journal of Management Medicine 13:234-250. Boger, E. 2003. ‘Electronic tracking board reduces ED patient length of stay at Indiana Hospital’, Journal of Emergency Nursing. 29:39-43. Boland, A., Dundar, Y., Bagust, A., Haycox, A., Hill, R., Mujica Moto, R., Walley, T. and Dickson, R. 2003. ‘Early thrombolysis for the treatment of acute myocardial infarction: a systematic review and economic evaluation’, Health Technology Assessment 7:1-136. Bond, P.A. 2001. ‘A staffed ED assessment room: impact on wait times for nonurgent patients at a Saudi Arabian hospital’, Journal of Emergency Nursing 27:394-395. Boyack, V.J. and Bucknum, A.E. 1991. ‘The quick response team: a pilot project’, Social Work in Health Care 16:55-68. Boyle, P., Pineault, R. and Roberge, D. 1992. ‘Assessing Quebec’s multicomponent program to reduce emergency room overcrowding’, Canadian Public Policy 1992;18:189-202. Brady, W.J., Brauning, N., Lee, D.S., Pietska, J.K., Kelly, P.O., Huff, S. and Martin, M.L. 2000 ‘Social needs in the elderly, recognition by emergency physicians and impact on additional medical care’, Academic Emergency Medicine 7:571. Brandt, C.P., Coffee, T., Yurko, L., Yowler, C.J. and Fratianne, R.B. 2000. ‘Triage of minor burn wounds: avoiding the emergency department’, Journal of Burn Care and Rehabilitation 21:26-28. Brebner, J.A., Ruddick-Bracken, H., Norman, J.N. and Page, J.G. 1996. ‘The nurse practitioner: management of minor trauma’, Accident and Emergency Nursing 4:43-46. Brenchley, J., Sloan, J.P. and Thompson, P.K. 2000. ‘Echoes of things to come. Ultrasound in UK emergency medicine practice’, Accident and Emergency Medicine 17:170-175. Bridges, J., Spilsbury, K., Meyer, J. and Crouch, R. 1999. ‘Older people in A&E: literature review and implications for British policy and practice’, Reviews in Clinical Gerontology 9:127-137. Brillman, J., Mathers-Dunbar, L., Graff, L., Joseph, T., Leikin, J., Schultz, C., Severance, H. and Werne, C. 1995. ‘Management of observation units’, Annals of Emergency Medicine 25:823-830. Reducing Attendances and Waits in Emergency Departments © NCCSDO 2005 203 Brillman, J. and Tandberg, D. 1994. ‘Observation unit impact on emergency department admissions for asthma’, American Journal of Emergency Medicine 12:11-14. Brillman, J.C., Doezeman, D. and Tandberg, D. 1997. ‘Triage: limitations in predicting need for emergency care hospital admissions’, Annals of Emergency Medicine 27: 493-500. Brockmeyer, E., Halstrom, H.L. and Jensen, A. 1948. ‘The life and works of A.K. Erlang’, Transactions of the Danish Academy of Technical Sciences 2. Brogan, C., Pickard, D., Gray, A., Fairman, S. and Hill A. 1998. ‘The use of out of hours health services: a cross sectional survey’, British Medical Journal 316:524-527. Brook, N. 2001. ‘Nurse-led discharge planning improves quality of care’, Nursing Times 97:40. Brookoff, D. and Minniti-Hill, M. 1994. ‘Emergency department based home care’, Annals of Emergency Medicine23:1101-1106. Brown, R. 2000. ‘Activities of accident and emergency consultants - a time and motion study’, Journal of Accident and Emergency Medicine 17:122-125. Browne, G.J., Giles, H., McCaskill, M.E., Fasher, B.J. and Lam L.T. 2001. ‘The benefits of using clinical pathways for managing acute paediatric illness in an emergency department’, Journal of Quality in Clinical Practice 21:50-55. Buesching, D.P., Jablonowoski, A. and Vesta, E. 1985. ‘Inappropriate emergency department visits’, Annals of Emergency Medicine 14:672-676. Burgher, S.W., Tandy, T.K. and Dawdy, M.R. 1998. ‘Transvaginal ultrasonography by emergency physicians decreases patient time in the emergency department’, Academic Emergency Medicine 5:802-807. Burnett, M.G. and Grover, S.A. 1996. ‘Use of the emergency department for nonurgent care during regular business hours’, Canadian Medical Association Journal 154:1345-1351. Byrne, G., Richardson, M., Brunsdon, J. and Patel, A. 2000. ‘An evaluation of the care of patients with minor injuries in emergency settings’, Accident and Emergency Nursing 8:101-109. Byrne, M., Murphy, A.W., Plunkett, P.K., McGee, H.M., Murray, A. and Bury, G. 2003. ‘Frequent attenders to an emergency department: a study of primary health care use, medical profile, and psychosocial characteristics’, Annals of Emergency Medicine 41:309-318. Bywaters, P. and McLeod, E. 2003. ‘Social care’s impact on emergency medicine: a model to test’, Emergency Medicine Journal 20:134- 137. Reducing Attendances and Waits in Emergency Departments © NCCSDO 2005 204 Bywaters, P., McLeod, E. and Cooke, M. 2002. ‘A diversionary tactic? Social work in an emergency assessment unit’, Nursing Older People 14:19-21. Calgary Health Region. [n.d.] ‘Regional collaborative for system improvement 2004-2005’ [Online]. Available(March 2005) at http://www.crha-health.ab.ca/qihi Cameron, P.A., Kennedy, M.P. and McNeil, J.J. 1999. ‘The effects of bonus payments on emergency service performance in Victoria’, Medical Journal of Australia 171:243-246. Campbell, J.L. 1994. ‘General practitioner appointment systems, patient satisfaction, and use of accident and emergency services-a study in one geographical area’, Family Practice 11:438-445. Cannaby, A., Parker, S. and Baker, R. 2003. ‘Identifying barriers to improving the process of discharging patients from hospital’, Primary Health Care 4:49-56. Cardello, D.M. 1992. ‘Implementation of a one-hour fast-track service: One hospital’s experience’, Journal of Emergency Nursing 18:239- 243. Cardin, S., Afilalo, M., Lang, E., Collet, J., Colacone, A., Tselios, C., Dankoff, J. and Guttman, A. 2003. ‘Intervention to decrease emergency department crowding: Does it have an effect on return visits and hospital readmissions?’ Annals of Emergency Medicine 41:173-185. Carlisle, R., Groom, L.M., Avery, A.J., Boot, D. and Earwicker, S. 1998. ‘Relation of out of hours activity by general practice and accident and emergency services with deprivation in Nottingham: longitudinal survey.’ British Medical Journal 316:520-523. Carver, J., Boyle, R., Chamberlain, D., Fisher, J., Quinn, T., Henderson, K. and Dancy, M. 2003. Review of Early Thrombolysis. Faster and Better Treatment for Heart Attack Patients. London: Department of Health. Castille, K. and Cooke, M. 2003. ‘One size does not fit all’, Journal of Accident and Emergency Medicine 20:119-120. Catellier, D.J., Conlisk, E.A., Vitt, C.M., Levin, K.S., Menon, M.P. and Upchurch, G.A. 2000. ‘A community-based pharmaceutical care program for the elderly reduces emergency room and hospital use’, North Carolina Medical Journal 61:99-103. Catnach, S., Pinkney, J., Woods, A. and Fairclough, P. 1992. ‘Fast track admission for patients with acute myocardial infarction’, British Medical Journal 304:380-381. Caunt, J. 1996. ‘The advanced nurse practitioner in CCU. Care of the critically ill’, 12:136-139. Celenza, A., Fothergill, J., Kupek, E. and Shaw, R.J. 1996. ‘Thunderstorm associated asthma: a detailed analysis of environmental factors’, British Medical Journal 312:604-607. Reducing Attendances and Waits in Emergency Departments © NCCSDO 2005 205 Chan, L., Reilly, K.M. and Salluzzo, R.F. 1997. ‘Variables that affect patient throughput times in an academic emergency department’, American Journal of Medical Quality 12:183-186. Chande, V.T. 1997. ‘Effects of a new fee-for-service Medicaid managed care plan on pediatric emergency department utilization... including commentary by Rousseak-Harsany E.’, Ambulatory Child Health 3:269-274. Chapman, D.B. and Torpy, J. 1997. ‘Healthcare expenditures. Development of a heart failure center: a medical center and cardiology practice join forces to improve care and reduce costs’, American Journal of Managed Healthcare. 3:431-437. Charalambous, C.P., Yarwood, S., Paschalides, C., Siddique, I., Paul, A. and Hirst, P. 2003. ‘Reduced delays in A&E for elderly patients with hip fractures’, Annals of the Royal College of Surgeons of England 85:200-203. Charles, A., Le Vasseur, S.A. and Castle, C. 1999. ‘Suturing of minor lacerations by clinical nurse specialists in the emergency department’, Accident and Emergency Nursing 7:34-38. Chen, R., Huang, Y. and Liu, X. 2003. ‘Probe into the second-line onduty nurses enhancing night shift nursing work quality in emergency room’, Chinese Nursing Research 17:42-43.
URI:	http://wrap.warwick.ac.uk/id/eprint/134

Request changes to a record

Actions (login required)

View Item